Going the extra mile to protect children against polio during the pandemic

Armed with vaccine carriers and finger markers, healthcare workers went the extra mile to vaccinate children with polio vaccines in the State of Sabah and the Federal Territory of Labuan in Malaysia.

After the declaration of the polio outbreak in December 2019, the Ministry of Health (MOH) Malaysia and the state and district health authorities immediately mobilised healthcare workers and partners in an immunisation campaign to stop the spread of polio in the communities. The campaign targeted children under 13 years old in all districts of Sabah and Federal Territory of Labuan.

WHO and UNICEF supported the Malaysian government with the provision of the monovalent polio vaccine type 2 (mOPV2), technical guidance, and with engagement of communities.

Facing a pandemic and other challenges

As polio campaign activities were making headway in response to the new outbreak, health authorities faced one of the biggest public health challenges in history – the COVID-19 pandemic.

“The impact of COVID-19 was profound and felt not only in Malaysia but around the world. However, as we deal with this virus, priority was given to ensure that essential health services like routine immunisation are not affected. Infection prevention and control precautions are well in place in health facilities to prevent COVID-19 transmission,” explained Tan Sri Dato’ Seri Dr. Noor Hisham bin Abdullah, Director General of Health Malaysia.

In addition to the pandemic, pre-existing challenges also persisted, including difficulty in reaching remote areas and highly mobile populations, as well as managing other disease outbreaks in the community, like cholera and dengue, and facing two types of circulating poliovirus.

Resuming the polio campaign

After a few months of temporarily downscaling the polio outbreak activities, health authorities adapted to the complex situation brought forth by the pandemic. Healthcare workers restarted work on the immunisation campaign in June 2020 with new protective measures in place, including use of appropriate personal protective equipment (PPE) such as masks, face shields and gloves, practicing frequent hand hygiene, and other non-pharmaceutical interventions.

“Disease waits for no one. We had to act immediately to respond to the COVID-19 pandemic as well as to other health challenges in the state. Once we were sure that our health workers can protect themselves and others from COVID-19, we immediately resumed the campaign against polio,” said Datuk Dr Christina Rundi, Director of the Sabah State Health Department.

Despite the continued challenges posed by COVID-19, every possible outreach opportunity was leveraged by health authorities to ensure that children in need receive the polio vaccine. They arranged fixed sites for parents to bring their children for vaccination, implemented drive-through and school immunization campaign, and went house-to-house to focus on reaching the highly mobile populations.

In Sabah, they also mobilised the flying doctor service so that the immunisation services reach the rural corners of the state.

“The Flying Doctor Service was instrumental in reaching out to some of the vulnerable population in rural areas. Whether by land, river, or air, we will make sure that we immunise every child against polio,” explained Dr Rundi.

To date, coverages for the first and second dose of the bivalent oral polio vaccine (bOPV) campaign are 98% and 96%, respectively, while coverages for the ongoing mOPV2 campaign are 88% for dose 1 and 81% for dose 2. The polio campaign activities will continue until 20 October 2020.

“We are proud of the polio campaign coverages we’ve seen, especially in the context of achieving this in the middle of the COVID-19 pandemic. This achievement is a testament to the efforts of our healthcare workers and the trust of the parents in our communities,” said Dr Noor Hisham. “As immunisation campaigns continue, rest assured that our healthcare workers administering the vaccinations are adhering to the SOPs so that your children are kept safe both from COVID-19 and polio.”

“It’s inspiring to see the people at the frontlines who make it their mission to reach every child with the polio vaccine. They climb mountains, cross rivers and seas, and drive through the bumpiest roads to make sure that we stop the polio outbreak in Malaysia,” said Dr Lo Ying-Ru Jacqueline, WHO Representative to Malaysia, Brunei Darussalam and Singapore. “We thank the healthcare workers for their excellent service and urge parents to vaccinate their children against polio.”