Gurugram exceeds target coverage of polio vaccine by nearly 15 percent

As part of a three-day intensified pulse polio immunisation (IPPI) drive, conducted earlier this week, an estimated 2,400 healthcare workers in the district immunised over 180,000 children under the age of five, by administering them drops of the oral polio vaccine (OPV).

With this drive, the health department exceeded its target, pegged at covering 160,000 infants, by nearly 15 percent. On an average, 72 children were immunised per healthcare worker involved in the campaign.

Health department officials said that while it is not uncommon for such immunisation drives to exceed their coverage targets, doing so amid the ongoing Covid-19 pandemic proved to be especially challenging, with a majority of the district’s healthcare workers currently being involved in the pandemic response.

Dr Naresh Garg, district immunisation officer, Gurugram, explained that an IPPI, which is conducted three to four times a year, usually enlists as many as 8,000 to 10,000 healthcare workers for door-to-door vaccination campaigns. The IPPI drive conducted in September and November this year, however, relied on not more than 2,500 healthcare to meet the same targets.

“A large portion of our staff is still engaged in the response to Covid-19. As such, this year, only about 2,240 healthcare workers, along with 176 supervising officers, were enlisted to carry out the IPPI drive earlier in September and now this month. In both cases, the field staff have had to work doubly hard to cover the same numbers. Our annual coverage target is 3.5 lakh children — the same as 2019. Like last year, it has been adequately met,” said Garg, adding that the department has also relied on assistance from volunteer NGOs working in the field of public health, as well as several ASHA (accredited social health activist) workers at the primary healthcare centre (PHC) level.

Health department data shows that a total of 184,849 children under the age five have been covered in the recently concluded IPPI. This was done as part of a sub-national immunisation campaign, which covered high-risk areas in 13 districts of Haryana. An earlier sub-national IPPI, held from September 22 to 24, had successfully immunised 128,529 children against polio (against a target coverage of 110,000 children) while at least another 0.1 million children were immunised early this year, as part of a National Immunisation Day campaign.

To make full use of their limited manpower this year, Garg said, health department staff, volunteers and contractual National Health Mission (NHM) staff carried out door-to-door awareness campaigns in high-risk areas, such as Tigra, Badshahpur, Wazirabad, Laxman Vihar and others, early last week, to let people know of the upcoming immunisation drive. “On Sunday, which was the first day of the IPPI, the outreach exercises successfully brought 87,701 children to about 400 pulse polio booths set up across PHCs and their sub-centres, allowing us to meet half our target in just one day,” said Garg.

Another 97,148 children were subsequently immunised on Monday and Tuesday in door-to-door vaccine drives conducted across the district by nearly 1,000 mobile teams, comprising two-members each, which in previous years were carried out by four-member teams. The entire exercise was overviewed by Dr Bindu Yadav, the World Health Organisation’s (WHO) surveillance medical officer in Gurugram, who said, “Polio drives are extremely manpower intensive, since we have to cover an extremely large number of children over several districts. It is a feat in itself that officials have been able to meet their targets with fewer resources this year. Each individual involved in the polio response has had to work to their fullest ability.”

However, she also added that a slight rejigging in immunisation criteria has also facilitated meeting of these targets. “Usually IPPIs cover a larger area, geographically speaking. This time, the drives were intensified in areas deemed especially high-risk. Therefore, we covered more people in smaller areas,” she said. Yadav pointed out that these areas are also those which are at the highest risk of Covid-19, due to poor sanitary conditions and densely packed homes.

Health department data shows that, out of the 18 primary healthcare centre blocks in Gurugram, only two blocks have not met their targeted coverage of the oral polio vaccine. These are Farukhnagar (where 96% of the target was met), and Bhora Kalan (which met only 85% of the target ). Officials said this was not alarming. “It is not uncommon for a couple of areas to have less coverage. These are typically poorer pockets with migrant populations that move around frequently. Overall though, we have been able to meet last year’s coverage target,” said Garg.

The last case of polio detected in Haryana dates back to 2011. The state was declared polio-free in 2014. However, immunisation drives against the infectious viral disease are important as they continue to resist the possibility of transboundary entry of the virus into the community. In addition, the health department also audits all registered cases of acute flaccid paralysis (AFP) in the district to check for the re-emergence of the virus. While officials were not able to provide data on AFP cases detected this year, they admitted it has been less than the previous years. “This is due to weakened disease surveillance in the face of pandemic, not because there are actually fewer number of cases of AFP. Therefore, meeting immunisation targets becomes all the more important, since surveillance is already affected,” Yadav added.