Frequently Asked Questions on Pulse Polio Activity

FREQUENTLY ASKED QUESTIONS AND ANSWERS

Q1. Why so many repeated rounds of OPV campaigns?

Ans.  For individual protection, every child during the first year of life should receive at least three doses of OPV (routine doses). Like any other vaccine, OPV is not 100%effective. Even children who have received all routine doses and pulse polio doses can get the disease. The only way to completely eliminate the risk of getting children paralysed by polio is to completely interrupt the circulation of wild poliovirus by administration of OPV to all under-five children over a few days and repeated a few times each year as happens during NID/SNID. It is essential that all children receive OPV during such NID/SNID rounds otherwise children in the area will continue to be affected by polio paralysis. Once polio is eradicated all children will be freed of the risk of getting polio throughout their life. Even areas that are currently

polio free, have to continue with NIDs/SNIDs to prevent the risk of importation of wild poliovirus into such areas.

Q.2 How long will Pulse Polio rounds continue? Will immunization activities stop soon?

Ans. National Immunization Days, Sub-National Immunization Days and Mop-Up campaigns need to continue to get rid of the virus from the country. SIAs will continue in India, for at least the next few years even after the last case is seen to ensure that polio is really gone from India and till it is certified that polio has been eradicated from the whole world.

Q3. How soon can we achieve polio eradication in India?

Ans.  After the programme suffered a setback in 2002 when 1600 cases were confirmed in the country, satisfactory progress has been made due to concerted efforts to improve the quality of SIAs coupled with increasing the number of rounds to 6-8 each year. This resulted in only 225 cases being confirmed in 2003, with further decline to 134 cases in 2004 and an all time low of only 66 cases in 2005. With the use of mOPV1 since April 2005 in high risk areas, which is continuing in the low season (when the effect of OPV is maximum) of 2006, India is poised to attain eradication in 2006. With the last case being recorded in Jan 13 2011, we are hopeful to eradicate by 2014.

Q4. Why we need to give OPV to children who have received routine OPV doses?

Ans. Routine OPV drops are given for individual protection of the children against polio.

However, like most vaccines OPV is not 100% effective. Some children do not develop complete immunity in spite of receiving all OPV doses. The only way to protect all children from polio is by stopping the circulation of wild polio virus from the environment. This is possible only if all children less than 5 years of age receive additional OPV doses simultaneously as is done during the NIDs/SNIDs. This helps to interrupt circulation of wild poliovirus and thus attain eradication. This is the only way to ensure that all children are safe and will not get polio.

Q5. Does administration of OPV lead to impotence or sterility?

Ans. No, OPV does not lead to any impotence or sterility. It is just a rumour which has been spread by some unscrupulous persons. OPV, in fact is one of the safest vaccines which has been in use for more than 30 years. Repeated doses of OPV minimize the risk of getting polio and are safe. Same OPV is being used for all communities in India and in several other countries including our neighbours Bangladesh and Pakistan. Even in Americas OPV was used successfully during the eradication phase. As with many successful programs, pulse polio programme also attracts the attention of a few people who try to spread rumours about the vaccine. None of these rumours have any basis and the people spreading such rumours are actually working against the interest of the children of this country.

Q6. Does administration of OPV have any side effects? Does it lead to illness in any child?

Ans. No, OPV does not have any side effects and it does not lead to any illness. Many children get sick every day due to different diseases and if these diseases occur during mass OPV campaigns, it is a mere coincidence.

Q7. Should OPV drops be given to newborn children?

Yes, OPV drops must be given to newborn children also, even if they were born

only a few hours ago.

Q8. Why do children get polio even after getting OPV?

Ans. As is true of any other vaccine or medicine, OPV also is not 100% effective. While adequate immunity will develop in most children receiving the vaccine, a few will still remain unprotected after receiving repeated doses. This small group of children who have received vaccine but have not developed adequate immunity can get polio if the wild poliovirus is circulating in the area. The fact that some children may get polio even after receiving polio drops, emphasizes the need to eradicate the poliovirus quickly. It is essential that for complete protection of all children wild poliovirus should be eradicated and this is only possible through repeated mass campaigns with OPV as during NIDs/SNIDs. If a few children do not receive OPV during NIDs/SNIDs, they maintain the circulation of wild poliovirus and this virus can then attack any child and produce paralysis in children that are not fully protected.

Unless we reach high coverage uniformly without pockets of children being left

out, there will always be a risk that some children who have been vaccinated could be affected by polio since they can still come into contact with virus.

Thus the only way to assure 100% protection from polio is to eliminate the poliovirus and thus stop it from circulating from child to child. It is therefore important that every child under 5 years of age receives polio drops during every pulse polio immunization round, in addition to their routine immunizations.

Q9. Should a child having diarrhoea or other sickness be given OPV drops?

Ans. OPV drops must be given to all children even those who have diarrhoea or other sickness.

Q10. Does administration of OPV interfere with administration of drugs or antibiotics being given to a sick child?

No, administration of OPV does not interfere with administration of other drugs or antibiotics.

Q11. Is there any difference in the vaccine if the colour of the liquid is different?

Ans. Usually the colour of the OPV is pink. However, the colour could be yellow or white also and there is no difference in the quality or type of vaccine.

Q12. Can an overdose be given accidentally and what would be the consequences?

Ans. There is no danger of overdose. Multiple doses do not cause adverse reactions.

Q13. Could it be that the Polio drops are not working properly? Are there problems with the vaccine in India?

Ans. Oral Polio vaccine, given multiple times has eliminated polio in the vast majority of countries in the world. It is the recommended vaccine to eradicate polio, and goes through rigorous testing arranged by WHO and the Government of India. The polio drops are working and there is no problem with the vaccine. A drop in the efficacy, or effectiveness, of vaccine can occur if it has not been maintained at the recommended temperatures as per the national protocol. However such a drop is unlikely because of the strict discipline and rigorous monitoring system built for cold chain maintenance. For example if the vaccine has lost efficacy due to faulty storage or long power cuts, the colour of the Vaccine Vial Monitor will change and clearly indicate that vaccine is no longer potent. The vaccine will then be discarded.

Q14. What is the cold chain?

Ans. The cold chain is a network of electrical and non-electrical equipment and human handlers who facilitate safe keeping and transportation of the vaccine from manufacturers’ level to the point of administration to children. During all this time the vaccine needs to be kept within a safe temperature range. Normally,  below freezing while being stored at state and district stores and between 2-8 degrees celsius in the period immediately prior to distribution and use.

Extract from IPPI guide published by MoHFW in 2006