Lifesaving polio vaccines reach 927,673 children: Liberia’s nationwide polio vaccination campaign

The national vaccination campaign was not an isolated effort but part of a larger regional cooperation initiative. Liberia conducted the synchronized campaign concurrently with neighboring countries including Sierra Leone, Mali, Burkina Faso, Guinea, and Ivory Coast. This cross-border approach aimed to immunize all eligible children, even those crossing national boundaries, showcasing an exemplary model of regional collaboration in public health.

During the national launch of the first round of the polio campaign conducted in Montserrado on May 10th, 2024, the Deputy Minister of Health/Chief Medical Officer, Dr. Catherine Cooper emphasized that polio is a public health emergency calling for a swift and coordinated response to protect children.
"Polio is a public health emergency, and the occurrence of the outbreak in Liberia requires us to make sure that all children are protected," she said. She also thanked all partners for their support and the MOH officers for demonstrating ownership and working alongside the partners.

In support of the national efforts , representatives from United Nations Children’s Fund (UNICEF), the World Health Organization (WHO), and other partners continued to offer their support throughout the campaign. "I am deeply moved by the dedication and commitment shown by everyone involved in this nationwide campaign. Our goal is clear - to ensure that every child under the age of five is vaccinated and protected from this debilitating disease. We believe that every child, no matter where they live, has the right to a healthy future. This campaign is not just about administering vaccines; it’s about safeguarding the future of Liberia’s children. Together, we can kick Polio out of Liberia," said Andy Brooks, UNICEF Representative in Liberia.

In a special video broadcast message on May 10th, 2024, the WHO Representative, Dr. Clement Peter, encouraged parents and guardians to ensure their children receive the polio vaccine, highlighting the dangers of polio as an infectious disease. "Polio is a very infectious disease and can lead to permanent paralysis and death in children as it attacks the nervous system," he said. Dr. Peter further highlighted the benefits of preventing polio through vaccination, "Polio is preventable through the administration of vaccines, which have enabled Liberia to achieve much progress in the fight against polio. The vaccines are safe, effective, and free." He encouraged all parents, caregivers, and guardians to ensure that all children under five years of age are vaccinated against this deadly disease. The messages by the government and partners seem to have been well received by parents across the country, who ensured their children were vaccinated.

During the launch, Rotarian Dr. Yatta Wapoe of the Rotary Club of Liberia briefed the gathering on the sampling process and results that led to the pronouncement of the polio outbreak. She called upon caregivers to ensure all children are protected.

Ahead of the second round to afford children a second dose for stronger immunity, extensive preparations were undertaken, drawing lessons from the first round. The Ministry of Health, in collaboration with its various partners at both national and subnational levels held reflection sessions on challenges and lessons learnt from the first round of supplemental immunization activities (SIAs) aiming to reach more children in the second round of the campaign. Hundreds of healthcare workers and mobile vaccination teams were deployed across the country, aiming to reach every child within the targeted age range, irrespective of their geographical location or socio-economic status.

Critical to the success of this polio vaccination campaign has been the coordination of various players at all levels, ensuring smooth operations. The Global Polio Eradication Initiative (GPEI) strategic partnership leads in the country held a meeting after the first round to understand the lessons learned and challenges faced, in order to make the second round a success. The GPEI coordination mechanism includes representatives from WHO, UNICEF, Centre for Disease Control and Prevention (US CDC), the Bill Gates Foundation (BMGF), GAVI the Vaccine Alliance, Rotary International, USAID, and other partners such as Africa CDC, African Field Epidemiology Network (AFENET), and Médecins Sans Frontières (MSF).
Additionally, at the technical level, coordination meetings with GPEI technical experts have been ongoing since the outbreak notification. A National Emergency Operations Center (EOC) has been operational throughout the campaign for technical coordination, led by an Incident Manager (IM). At the end of each day of the campaign, district teams reviewed the progress made and relayed the information to the National Emergency Operations Center (EOC).

The WHO supported with the provision of 32 vehicles to facilitate national supervision and monitoring of vaccination activities in the 15 counties across Liberia

Thanks to the support of the GPEI partners including WHO, vaccination teams took the vaccines to the people reaching every eligible child to control the spread of cVDPV2 in Liberia.

After a child receives two drops of the oral polio vaccine, their finger was marked, followed by the marking of the house where the child lives. These were some of the verification features used by the independent monitors and lot quality assurance sampling (LQAS) surveyors during their supervision checks to identify any missed children. At the end of Round 2, 86% of the all the 98 districts surveyed for quality coverage had 90% vaccination coverage or more. This was a big improvement in performance from 65% of the districts that had achieved such a performance in Round 1. WHO recommends that at least 80% of all implementing districts attain this quality measure to ensure children’s protection.

The success of the campaign greatly depended on the dedication of the frontline workers involved in community mobilization and vaccine administration during the campaign period.

During the visit of football legend Micheal Essien and his wife Akosua Puni Essien to Liberia prior to commencement of the campaigns’ second round, the couple engaged in learning about immunization and polio eradication efforts in Liberia, understanding the vaccine infrastructure, and listening to personal stories from families and children receiving vaccines as well as the health care workers administering them. Michael also participated in a friendly football game with young athletes in Liberia.
"Through unity and determination, most of the world has overcome the shadow of polio. Let its eradication be a beacon of hope, reminding us that with perseverance, even the most daunting challenges can be conquered," said Michael Essien. “I am inspired by the tenacity of the Liberian people, and I know that together, we will finish the job so no child ever has to live in fear of polio again.”

The use of the Open Data Kit (ODK) platform to update data in real time was instrumental in mapping the covered areas for both vaccination and social mobilization coverage, followed by physical verification by independent monitors.

Despite challenges, teams supported by WHO and other partners traveled extensively across the 15 counties in Liberia using various modes of transportation, including canoes, cars, and motorbikes, to ensure that eligible children receive the protection they need for a polio-free Liberia.

Polio surveillance and ongoing Routine Immunization (RI) activities such as monthly health facility outreaches, quarterly Periodic Intensified Routine Immunization (PIRIs), and continuous community engagement activities aligned to primary health care services remain essential components of the broader ongoing effort to eradicate polio in Liberia.

As part of the polio campaign, it was crucial for vaccination teams going house to house to ask about suspected cases of Acute Flaccid Paralysis (AFP) in the community for early identification and reporting. During the two rounds of the polio campaign, a total of 19 cases were identified and reported for further investigation—9 cases in the first round and 10 in the second round.
The dedication and hard work of Liberia’s healthcare workers, supported by international partners and local communities, have brought the country closer to eradicating polio. This comprehensive and coordinated effort demonstrates the power of partnership, dedication, collaboration and commitment to eradicate polio as public health emergency.