Polio FAQs — Knowledge Centre

This is the Knowledge Centre's quick-reference set of answers. For the longer parent-facing version, see the main polio FAQs; for travel documents, see the NADRA polio certificate guide.

About the disease

What is polio? Poliomyelitis is a viral infection that attacks the nervous system. Most infections cause no symptoms at all; roughly one in two hundred causes irreversible paralysis, usually in the legs. In a small proportion of paralytic cases the muscles used for breathing are affected, which can be fatal.

How does it spread? Mainly by the faecal-oral route — through water, food or hands contaminated with the stool of an infected person. Poor sanitation and crowded living conditions accelerate transmission, which is why dense, underserved urban neighbourhoods appear repeatedly in Pakistan's case record.

Who is at risk? Children under five, overwhelmingly. Adults can be infected but paralysis is rarer.

Is there a cure? No. Physiotherapy, braces and surgery can improve function, but nerve cells destroyed by poliovirus do not regenerate. Prevention through vaccination is the only protection.

About the vaccine

Which vaccines are used in Pakistan? Campaigns use bivalent oral polio vaccine (bOPV) — the two drops — which protects against wild types 1 and 3. Inactivated polio vaccine (IPV), an injection, is given through routine immunisation and covers all three types. Novel oral polio vaccine type 2 (nOPV2) is used specifically for variant type 2 outbreak response.

Why do children need drops again and again? Each oral dose gives partial protection; immunity builds with repeated doses. In places with heavy diarrhoeal disease and poor sanitation, more doses are needed to reach full protection than in low-transmission settings. A child who has had drops five times is better protected than one who has had them twice — which is why campaigns return.

Is the vaccine safe? Is it permissible in Islam? Oral polio vaccine has been given billions of times worldwide and is one of the most extensively used vaccines in history. On the religious question, Pakistani and international ulema, the Council of Islamic Ideology and the Islamic Advisory Group convened under the Organisation of Islamic Cooperation have all affirmed that polio vaccination is permissible. See Muslim ulema dispel misconceptions.

Can a sick child be vaccinated? Yes. Mild illness — a cold, a fever, diarrhoea — is not a reason to skip the drops. If a child is seriously unwell, ask the vaccination team or your nearest health facility.

About the programme

How often do campaigns run? National immunisation days target every child under five in the country, around 45 million children. Sub-national rounds target districts selected by risk. Additional case-response rounds follow any confirmed case or positive environmental sample. See the eradication strategy.

How does the programme know where the virus is? Through two systems: investigation of every case of sudden floppy paralysis in a child under 15, and routine sampling of sewage at fixed sites nationwide. See polio surveillance in Pakistan.

How many cases has Pakistan reported? Roughly 20,000 a year in the early 1990s, falling to 8 in 2017, rising to 147 in 2019, then 1 in 2021, 74 in 2024 and 31 in 2025. The province-wise record has the full series and the district tracker has the current year.

What should I do if a team never came to my house? Call the Sehat Tahaffuz helpline on 1166. It is toll-free and handles missed-vaccination reports as well as general queries.

More resources

Reports, plans and datasets are collected in Knowledge Centre reports and online resources.