Top

Published in:

Open Access 01-12-2021 | Polio Virus | Research article

An experience of mass administration of fractional dose inactivated polio vaccine through intradermal needle-free injectors in Karachi, Sindh, Pakistan

Authors: Umar Farooq Bullo, Jaishri Mehraj, Syed Musa Raza, Shumaila Rasool, Noreen Naz Ansari, Ahmed Ali Shaikh, Zamir Ali Phul, Sohail Ahmed Memon, Rehan Iqbal Baloch, Zahoor Ahmed Baloch, Shoukat Ali Chandio

Published in: BMC Public Health | Issue 1/2021

Abstract

Background

Inactivated Polio Vaccine (IPV) campaign was conducted in February 2019 in Karachi where needle-free injectors were introduced for the administration of the fractional dose of IPV (fIPV) on a large scale. This study aimed to determine the impact of needle-free injectors on vaccination coverage.

Methods

In four towns of Karachi, fIPV was given using needle-free injectors “PharmaJet Tropis ID”. Whereas, in six towns full dose of IPV was administered to children of 4–59 months of age. Cluster surveys through rapid convenience assessment method were conducted after the completion of vaccination activity.

Results

A total of 33,815 households’ data was analyzed. Among these, 27,650 (82.8%) children were vaccinated. In fIPV areas, 85.3% of children were vaccinated compared to 79.5% in full dose IPV areas. A comparison of reasons for unvaccinated showed that 1.6% of parents do not give importance to vaccination in fIPV areas compared to 4.2% in full IPV areas (p-value < 0.0001). More children were not vaccinated due to fear of injection 1.8% in full IPV areas compared to 0.7% in fIPV areas (p-value < 0.0001). The source of campaign information shows that more frequent mobile miking 3.1% was observed in fIPV areas compared to 0.4% in full IPV areas (p-value < 0.0001).

Conclusions

Our analysis supports the fractional dose of IPV in mass campaigns to achieve good vaccination coverage especially using needle-free injectors “PharmaJet Tropis ID” and vigorous social mobilization activities are expedient in accomplishing high coverage.

Global Polio Eradication Initiative. Wild poliovirus list: list of wild poliovirus by country and year. 2019; Available from http://www.polioeradication.org/Dataandmonitoring/Poliothisweek/Wildpolioviruslist.aspx.

Sheikh MA, Makokha F, Hussein MA, Mohamed G, Mach O, Humayun K, et al. Combined use of inactivated and oral poliovirus vaccines in refugee camps and surrounding communities—Kenya, December 2013. MMWR Morb Mortal Wkly Rep. 2014;63(11):237–41.PubMedPubMedCentral

World Health Organization. Meeting of the strategic advisory group of experts on immunization, November 2013: conclusions and recommendations. Wkly Epidemiol Rec. 2014;89(01):1–20.

World Health Organization. Meeting of the strategic advisory group of experts on immunization, April 2015: conclusions and recommendations. Wkly Epidemiol Rec. 2015;90(22):261–80.

Shirreff G, Wadood MZ, Vaz RG, Sutter RW, Grassly NC. Estimated effect of inactivated poliovirus vaccine campaigns, Nigeria and Pakistan, January 2014–April 2016. Emerg Infect Dis. 2017;23(2):258–63. https://doi.org/10.3201/eid2302.161210.CrossRefPubMedPubMedCentral

Fahmy K, Hampton LM, Langar H, Patel M, Mir T, Soloman C, et al. Introduction of inactivated polio vaccine, withdrawal of type 2 oral polio vaccine, and routine immunization strengthening in the Eastern Mediterranean Region. J Infect Dis. 2017;216(suppl_1):S86–93. https://doi.org/10.1093/infdis/jix133.CrossRefPubMedPubMedCentral

World Health Organization. Polio vaccines: WHO position paper, January 2014. Wkly Epidemiol Rec. 2014;89:73–92.

Mohammed AJ, AlAwaidy S, Bawikar S, Kurup PJ, Elamir E, Shaban MM, et al. Fractional doses of inactivated poliovirus vaccine in Oman. N Engl J Med. 2010;362(25):2351–9.CrossRef

Anand A, Zaman K, Estívariz CF, Yunus M, Gary HE, Weldon WC, et al. Early priming with inactivated poliovirus vaccine (IPV) and intradermal fractional dose IPV administered by a microneedle device: a randomized controlled trial. Vaccine. 2015;33(48):6816–22. https://doi.org/10.1016/j.vaccine.2015.09.039.CrossRefPubMed

10.

Resik S, Tejeda A, Mach O, Fonseca M, Diaz M, Alemany N, et al. Immune responses after fractional doses of inactivated poliovirus vaccine using newly developed intradermal jet injectors: a randomized controlled trial in Cuba. Vaccine. 2015;33(2):307–13. https://doi.org/10.1016/j.vaccine.2014.11.025.CrossRefPubMed

11.

Snider CJ, Zaman K, Estivariz CF, Yunus M, Weldon WC, Wannemuehler KA, et al. Immunogenicity of full and fractional dose of inactivated poliovirus vaccine for use in routine immunisation and outbreak response: an open-label, randomised controlled trial. Lancet. 2019. https://doi.org/10.1016/S0140-6736(19)30503-3.

12.

Gamage D, Mach O, Ginige S, Weldon WC, Oberste MS, Jeyaseelan V, et al. Poliovirus type 2 seroprevalence following full-or fractional-dose inactivated poliovirus vaccine in the period after Sabin type 2 withdrawal in Sri Lanka. J Infect Dis. 2019;219(12):1887–92. https://doi.org/10.1093/infdis/jiz026.CrossRefPubMed

13.

Product information. PharmaJet’s Tropis needleless injection device is safe, fast and easy. Available from: https://pharmajet.com/tropis-id/ [Accessed 14 Nov 2020].

14.

Daly C, Molodecky NA, Sreevatsava M, Belayneh AD, Chandio SA, Partridge J, et al. Needle-free injectors for mass administration of fractional dose inactivated poliovirus vaccine in Karachi, Pakistan: a survey of caregiver and vaccinator acceptability. Vaccine. 2019. https://doi.org/10.1016/j.vaccine.2019.12.059.

15.

Pervaiz A, Mbaeyi C, Baig MA, Burman A, Ahmed JA, Akter S, et al. Fractional-dose inactivated poliovirus vaccine campaign—Sindh Province, Pakistan, 2016. MMWR Morb Mortal Wkly Rep. 2017;66(47):1295–9. https://doi.org/10.15585/mmwr.mm6647a4.CrossRefPubMedPubMedCentral

16.

Yousafzai MT, Saleem AF, Mach O, Baig A, Sutter RW, Zaidi AK. Feasibility of conducting intradermal vaccination campaign with inactivated poliovirus vaccine using Tropis intradermal needle-free injection system, Karachi, Pakistan. Heliyon. 2017;3(8):e00395. https://doi.org/10.1016/j.heliyon 2017. e00395. eCollection 2017 Aug.CrossRefPubMedPubMedCentral

17.

Saleem AF, Mach O, Yousafzai MT, Khan A, Weldon WC, Oberste MS, et al. Needle adapters for intradermal administration of fractional dose of inactivated poliovirus vaccine: evaluation of immunogenicity and programmatic feasibility in Pakistan. Vaccine. 2017;35(24):3209–14. https://doi.org/10.1016/j.vaccine.2017.04.075.CrossRefPubMedPubMedCentral

18.

Bahl S, Verma H, Bhatnagar P, Haldar P, Satapathy A, Kumar KN, et al. Fractional-dose inactivated poliovirus vaccine immunization campaign - Telangana State, India, June 2016. MMWR Morb Mortal Wkly Rep. 2016;65(33):859–63. https://doi.org/10.15585/mmwr.mm6533a5.CrossRefPubMed

19.

WHO Collaborative Study Group. Combined immunization of infants with oral and inactivated poliovirus vaccines: results of a randomized trial in the Gambia, Oman, and Thailand. Bull World Health Organ. 1996;74(3):253–68. https://doi.org/10.1093/infdis/175.Supplement_1.S215.CrossRef

20.

Resik S, Tejeda A, Mas Lago P, Diaz M, Carmenates A, Sarmiento L, et al. Randomized controlled clinical trial of fractional doses of inactivated poliovirus vaccine administered intradermally by needle-free device in Cuba. J Infect Dis. 2010;201(9):1344–52. https://doi.org/10.1086/651611.CrossRefPubMed

21.

Yufika A, Wagner AL, Nawawi Y, Wahyuniati N, Anwar S, Yusri F, et al. Parents’ hesitancy towards vaccination in Indonesia: a cross-sectional study in Indonesia. Vaccine. 2020;38(11):2592–9. https://doi.org/10.1016/j.vaccine.2020.01.072.CrossRefPubMed

22.

Habib MA, Soofi S, Cousens S, Anwar S, Haque NU, Ahmed I, et al. Community engagement and integrated health and polio immunization campaigns in conflict-affected areas of Pakistan: a cluster randomized controlled trial. Lancet Glob Health. 2017;5(6):e593–603. https://doi.org/10.1016/S2214-109X(17)30184-5.CrossRefPubMedPubMedCentral

Title: An experience of mass administration of fractional dose inactivated polio vaccine through intradermal needle-free injectors in Karachi, Sindh, Pakistan
Authors: Umar Farooq Bullo
Jaishri Mehraj
Syed Musa Raza
Shumaila Rasool
Noreen Naz Ansari
Ahmed Ali Shaikh
Zamir Ali Phul
Sohail Ahmed Memon
Rehan Iqbal Baloch
Zahoor Ahmed Baloch
Shoukat Ali Chandio
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Polio Virus
Vaccination
Published in: BMC Public Health / Issue 1/2021
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-020-10041-8

At a glance: The STEP trials

Springer Medicine

An experience of mass administration of fractional dose inactivated polio vaccine through intradermal needle-free injectors in Karachi, Sindh, Pakistan

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2021

Correction to: Self-reported suboptimal sleep and receipt of sleep assessment and treatment among persons with and without a mental health condition in Australia: a cross sectional

Explaining better hearing in Norway: a comparison of two cohorts 20 years apart - the HUNT study

Survival analysis of factors affecting the timing of COVID-19 non-pharmaceutical interventions by U.S. universities

Chronic respiratory disease mortality and its associated factors in selected Asian countries: evidence from panel error correction model

Numbers of close contacts of individuals infected with SARS-CoV-2 and their association with government intervention strategies

Young migrants’ sexual rights in Sweden: a cross-sectional study