Polio in Egypt
The Last Battle
Egypt has suffered for long from polio; a disease that has been endemic in the country for almost 3000 years, as illustrated in Pharaonic inscriptions, and infected millions of children in Egypt and the world until 1955 when scientists discovered the first vaccine against poliovirus. The vaccine was in the form of an injection till 1961 when an oral route of administration was discovered.
Since then, many countries have succeeded in eradicating the disease by vaccinating children under five years old. Egypt joined the list in 2006 with the World Health Organization (WHO) and UNICEF declared that Egypt was polio-free after the last case was discovered in 2004. This was due to the extensive vaccination coverage in all the governorates of Egypt through seven doses within the schedule of routine immunizations and the additional doses through periodic national campaigns.
In 2018, Egypt entered the final phase of eradicating the disease completely and to ensure that there are no new cases due to any viruses coming from abroad. The global strategy in polio eradication recommends introducing an additional dose via injection to the dose of oral vaccination in the fourth month, the remaining six doses to remain oral.
Below are the FAQs about the disease and changing the vaccination system:
What is Polio?
Polio is a highly contagious disease, usually affecting children from one to five years of age. Its primary symptoms include fever, stress, headache, vomiting and pain in the limbs. The disease can cause paralysis that is often, and still, untreatable. In late stages, polio can lead to death.
How is Polio transmitted?
Polio virus is transmitted through contaminated food and drink by the feces of an infected child to another due to poor hygiene. If a child is not immunized, the virus will multiply in the intestine, attack the nervous system and can cause complete paralysis in one limb within hours.
Does Polio affect children older than 5 years old?
It is very rare for a person to be affected by polio after the age of 5, so we vaccinate all children living in Egypt, whether Egyptians or non-Egyptians, from age 0-5 years.
Polio and Egypt
What is the situation of Polio in Egypt?
The last confirmed polio case was reported in 2004, and it was declared that Egypt was completely polio-free in 2006.
How to verify that Egypt is polio-free?
The Ministry of Health and Population (MoHP), in collaboration with the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF), implements a high-quality monitoring system for all cases of acute flaccid paralysis in Egypt. This is beside sampling and analysis of sewage streams in verified laboratories inside and outside Egypt to exclude the possibility of polio.
If Egypt is polio-free, why should we continue vaccinating our children?
Repeated immunization through various campaigns ensures that all children living in Egypt are protected from poliovirus coming from outside Egypt. It also ensures that no child under 5 years old would miss a vaccination dose.
Protection against Polio
Who needs the Polio vaccine?
For protection against polio, all children living in Egypt, whether Egyptians or non-Egyptians, should be vaccinated from the age of 1 to 18 months.
When are children vaccinated against Polio?
Children are vaccinated through:
Routine immunization (shown in the vaccination schedule) through 7 doses: at birth, the second month, the fourth month, the sixth month, the ninth month, one year, and one & half year.
National campaigns (even if they were recently vaccinated within their schedule): All children aged 1 to 5 years.
Is it better to vaccinate my under-5 children at a private clinic, health office or mobile vaccination team?
The best place for vaccination is the health office/unit of MoHP, where the vaccine is free, monitored and always available.
Types of Polio vaccine
Are there different types of Polio vaccine? What are the differences?
There are two highly-effective types:
Oral Polio Vaccine (OPV): More effective in preventing transmission of the virus from one child to another and creating strong immunity in the community, and therefore used in countries that are still fighting polio.
Inactivated Polio Vaccine (IPV): More effective in strengthening individual immunity, and therefore used by countries that have eradicated polio.
What change will happen to the routine Polio immunization program?
Only the fourth month dose of OPV will be accompanied by an additional injection (shot) of the same vaccine, all other doses will remain oral. Thus, when the child visits the health unit/office at the age of 4 months, he or she will receive oral drops and two shots: Polio and Pentavalent (Hepatitis B - Flu - Tetanus - Diphtheria - Pertussis).
If OPV has succeeded in eradicating polio, why is an additional IPV dose introduced?
Based on the recommendations of WHO and UNICEF, countries in areas that are near to completely eradicating polio need to introduce IPV to increase the immunity of children against the poliovirus.
Is it ok to give the child two forms of the same vaccine and two shots for different vaccines in one visit?
Yes. It is ok to give more than one form of the same vaccine and different vaccinations in the same session. For example, in the 18th month vaccination session the child receives MMR (Mumps, Measles and Rubella) shot as well as another shot for the DPT vaccine (Diphtheria, Pertussis and Tetanus).
Does the IPV vaccine affect male or female child’s fertility?
No, IPV has no effect on fertility. All what’s said about IPV causing sterility are rumors.
Safety and validity of vaccines
What is the source of the new vaccine?
All OPV and IPV used in routine immunization and national campaigns are imported from a single source which is certified and approved by WHO and UNICEF. Random samples from the vaccines are examined by the Egyptian Drug Control Board before distribution and usage.
How do we make sure that the vaccine is valid and effective?
WHO, UNICEF and the MoHP ensure the quality and efficacy of vaccines through the following criteria:
Each bottle has production and expiration dates and another label called a "vaccine monitor" that indicates its validity. Vaccination teams and supervisors have been trained to review the validity of all bottles prior to distribution and given strict instructions to exclude any bottle in doubt.
MoHP applies the "cold chain" system; a high quality system to ensure that each bottle of the vaccine is preserved from damage during transportation and storage. Cold chain is under the strict supervision of MoHP, WHO and UNICEF.
The latest and most accurate safe injection methods are followed where syringes are used only once per vaccine.
What is a "cold chain" system?
The cold chain is a temperature-controlled supply chain that consists of a series of storage and distribution activities, along with associated equipment and logistics, which maintain a desired low-temperature range.
MoHP provides a highly efficient cold chain system to transport polio vaccines from cold rooms in the Ministry’s premises to the health units/offices through equipped vehicles. The vaccines are stored in freezers and transferred in heat insulated boxes for the vaccination sessions.
This system also ensures that the remaining doses of routine vaccination sessions will not be re-stored and re-used. Instead, these bottles will be culled and new bottles be used in each session.