The United Nations health agency, in partnership with other organizations, is set to launch a massive polio vaccination campaign on Sunday aimed at reaching 640,000 Palestinian children in Gaza. The campaign comes amid a devastating war that has severely compromised the territory’s healthcare system, creating a challenging backdrop for the vaccination effort.
The urgent campaign follows the recent detection of Gaza’s first polio case in 25 years—a 10-month-old boy who is now paralyzed in one leg. According to the World Health Organization (WHO), the presence of this paralysis case suggests that there could be hundreds more infected individuals who are not showing symptoms.
The Threat of Polio: A Silent Danger
Polio, a highly contagious viral infection, often presents without symptoms in most cases, with those affected typically recovering within a week. However, when polio leads to paralysis, the damage is usually permanent and can be fatal if it affects the muscles that assist in breathing. Currently, there is no cure for the disease, making vaccination the only effective means of prevention.
The campaign is critical not only because of the boy’s condition but also due to the risk of the virus spreading unnoticed among the population. The WHO has warned that the outbreak could expand rapidly if not swiftly contained, especially given Gaza’s damaged healthcare infrastructure and displaced population.
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Coordinated Efforts Amid Conflict
The vaccination drive faces significant logistical hurdles, including the destruction of Gaza’s roads and healthcare facilities. Despite these challenges, the WHO announced on Thursday that it has secured an agreement with Israeli authorities to allow limited pauses in hostilities to facilitate the campaign. However, the large-scale nature of the effort is complicated by the widespread destruction and the displacement of nearly 90% of Gaza’s population.
Dr. Rik Peeperkorn, WHO’s representative in the Palestinian territories, stated that the three-day vaccination campaign in central Gaza will commence on Sunday during a “humanitarian pause” between 6 a.m. and 3 p.m. Additional time may be granted if necessary. Following this, the vaccination efforts will shift to southern and northern Gaza during similar pauses, as coordinated with Israeli authorities.
Who Will Be Vaccinated and How
The campaign aims to immunize 640,000 children under the age of 10. Each child will receive two drops of the oral polio vaccine during two separate rounds, with the second dose administered four weeks after the first. This schedule is designed to provide robust protection against the virus and help prevent further transmission.
Vaccination sites have been established across Gaza, both inside and outside the Israeli evacuation zones, spanning from Rafah in the south to northern Gaza. The Ramallah-based Health Ministry reported that over 400 fixed vaccination sites, including healthcare centers, hospitals, clinics, and field hospitals, will be operational. In Khan Younis alone, where the population density is the highest, there are 239,300 children under 10 who will receive the vaccine.
In addition to fixed sites, approximately 230 outreach locations—community gathering points not traditionally used as medical centers—will be set up to ensure broad access to the vaccine across the territory.
Vaccine Supply and Distribution Challenges
A total of 1.3 million vaccine doses have been transported through the Kerem Shalom checkpoint and are currently stored in cold-chain facilities in Deir al-Balah to maintain their efficacy. An additional 400,000 doses are expected to arrive soon to support the campaign’s second round.
The vaccine distribution will be managed by over 2,000 medical volunteers, who will transport doses to the vaccination sites. Despite these efforts, the operation remains fraught with logistical challenges. An estimated 65% of Gaza’s road network has been damaged, and 19 of its 36 hospitals are currently non-operational, severely limiting mobility and healthcare access.
Navigating War Zones and Safety Risks
The ongoing conflict has fragmented Gaza, making travel between northern and southern areas perilous due to ongoing Israeli military operations. Aid groups have faced significant security concerns, with some suspending operations after convoys were targeted. WHO’s efforts are further complicated by the inability to conduct house-to-house vaccinations, a method commonly used in other polio campaigns.
Peeperkorn acknowledged these challenges but remained optimistic, stating, “It is feasible if all the pieces of the puzzle are in place.”
Importance of Complete Vaccination and Potential Side Effects
WHO advises that children generally need three to four doses of the oral polio vaccine to be fully protected, with each dose consisting of two drops. In certain cases, especially among malnourished children or those with other health issues, up to 10 doses may be required for full immunity.
Though extremely rare, the oral polio vaccine does carry a minimal risk: in about 1 in 2.7 million doses, the live virus in the vaccine can cause paralysis in the recipient. However, billions of doses have been administered worldwide, proving the vaccine’s safety and effectiveness.
Origin of the Outbreak: A Rare Mutation
The current polio outbreak in Gaza was triggered by a mutated virus derived from an oral polio vaccine. The oral vaccine contains a weakened live virus that, in rare instances, can be shed by vaccinated individuals and evolve into a form capable of sparking new outbreaks.
