Exploring the path to polio eradication: insights from consecutive seroprevalence surveys among Pakistani children

Imtiaz Hussain, Muhammad Umer, Ahmad Khan, Muhammad Sajid, Imran Ahmed, Kehkashan Begum, Junaid Iqbal, Muhammad M. Alam, Rana M. Safdar, Shahzad Baig, Arie Voorman, Jeffrey Partridge, Sajid Soofi

Research output: Contribution to journalArticlepeer-review


Introduction: After trivalent oral poliovirus vaccine (tOPV) cessation, Pakistan has maintained immunity to type 2 poliovirus by administering inactivated polio vaccine (IPV) in routine immunization, alongside monovalent OPV type 2 (mOPV2) and IPV in supplementary immunization activities (SIAs). This study assesses the change in poliovirus type 2 immunity after tOPV withdrawal and due to SIAs with mOPV2 and IPV among children aged 6–11 months. Methods: Three cross-sectional sequential serological surveys were conducted in 12 polio high-risk areas of Pakistan. 25 clusters from each geographical stratum were selected utilizing probability proportional to size. Results: Seroprevalence of type 2 poliovirus was 49%, with significant variation observed among surveyed areas; <30% in Pishin, >80% in Killa Abdullah, Mardan & Swabi, and Rawalpindi. SIAs with IPV improved immunity from 38 to 57% in Karachi and 60 to 88% in Khyber. SIAs with IPV following mOPV2 improved immunity from 62 to 65% in Killa Abdullah, and combined mOPV2 and IPV SIAs in Pishin improved immunity from 28 to 89%. Results also reflected that immunity rates for serotypes 1 and 3 were consistently above 90% during all three phases and across all geographical areas. Conclusion: The study findings highlight the importance of implementing effective vaccination strategies to prevent the re-emergence of poliovirus. Moreover, the results provide crucial information for policymakers working toward achieving global polio eradication.

Original languageEnglish
Article number1384410
JournalFrontiers in Public Health
Publication statusPublished - 2024


  • Pakistan
  • eradication
  • poliovirus
  • seroprevalence
  • type 2 immunity


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