More than 50 million children worldwide have missed their essential polio immunisations this year, after door-to-door vaccination campaigns were paused and medical staff redirected amid the height of the COVID-19 pandemic.

Experts say the suspension of immunisations — which were halted because they did not comply with global physical distancing recommendations — could have a particularly worrisome impact for the Pacific and Southeast Asia, because of the region’s weak health systems and poor immunisation rates.

While stopping polio vaccinations was “necessary” given the unparalleled speed of COVID-19 infections through March, April and May, the decision is expected to increase the likelihood of future polio cases significantly. 

"When vaccination campaigns are delayed it becomes harder to maintain high immunity against polio, thus leaving children vulnerable to infection and serious illnesses,” Luo Dapeng, a World Health Organisation country representative in Papua New Guinea, told Global Citizen. “The COVID-19 response has necessitated the postponement of polio immunisation campaigns in countries such as the Philippines and Malaysia, and has caused the delay of a preventive polio immunisation campaign in Papua New Guinea.” 

While responding to #COVID19 is now the priority, our resolve to finish #polio remains. The global eradication effort will redouble efforts as soon as it is safe, ready to recover lost ground and tackle the barriers to #EndPolio. https://t.co/LdHfapzHk3@EndPolioNow

— Rebecca Martin, PhD (@DrMartinCDC) April 6, 2020

In 2018, Papua New Guinea recorded its first case of polio in 18 years. 

A diagnosis of vaccine-derived poliovirus was confirmed, which is an extremely rare, mutated strain of the weaker poliovirus used in vaccinations. This form of polio develops in regions with inadequate sanitation, insufficient access to clean water and low immunisation rates.

The initial polio case was reported in a province where just 61% of children had received the endorsed three vaccine doses.

In 2019, Malaysia, Indonesia and the Philippines similarly reported vaccine-derived cases for the first time in decades.

Investigations found that 23 of 199 children who lived in close contact to the first Malaysian child to be infected had not been vaccinated. In the Philippines, just 40% of children under the age of 5 have had the polio injection. Full vaccine coverage in Indonesia sits at around 80%.

Polio eradication requires at least 95% of all children under 5 to be immunised.

In July, polio vaccinations began again globally for the first time in four months. 

The Global Polio Eradication Initiative (GPEI), the key public-private partnership organisation in the fight to end polio, said it was vital that immunisation programs resume as soon as safely possible, despite the ongoing pandemic.

Hamid Jafari, a director of polio eradication at the GPEI, said various COVID-19 prevention methods had been put in place.

"Our teams have been working to support the COVID-19 response since the beginning of the pandemic,” Jafari said in a GPEI statement. “We must now ensure that we work with communities to protect vulnerable children with vaccines, whilst ensuring strict safety and hygiene measures to prevent further spread of COVID-19.” 

Activists and health organisations are now urging all nations to adopt measures to prevent both COVID-19 and polio, and for developed countries to pledge further funds to the GPEI so it can continue its life-saving polio eradication work.

Dapeng said the best chance to stop the spread of both diseases is for communities and countries to work together.

“For both diseases, transmission of the virus can be stopped when communities act together to adopt measures which have been shown to protect against infection and spread of the virus,” he told Global Citizen. “Political leaders and health care providers can keep the issue of polio eradication in the forefront of discussions on important public health issues and create better awareness of the importance of vaccination in preventing illness.”

Call on world leaders to pledge new funds to the GPEI by taking action here.