‘Positive’ start to polio vaccination rollout in Gaza despite continued fighting

A complex, large-scale vaccination campaign to inoculate children against the newly emerged threat of polio in the Gaza Strip has begun successfully despite ongoing fighting in the territory, according to UN officials and local health authorities.

Infectious conditions such as dysentery, pneumonia and severe skin diseases are affecting more than 150,000 people in Gaza, the World Health Organization (WHO) estimates, amid a dire humanitarian crisis and unsanitary conditions caused by Israel’s campaign to annihilate Hamas in the wake of 7 October.

Aid workers have warned for months of possible outbreaks of other life-threatening and highly contagious diseases such as polio and cholera; those fears were confirmed last week when the territory recorded its first case of type 2 polio since 1999 in a 10-month-old boy, who had begun crawling early, but is now paralysed in one leg. The WHO estimates that hundreds more people are probably infected, but not showing symptoms.

The campaign faces huge challenges. WHO officials say at least 90% of 640,000 children under 10 must be vaccinated with two drops of oral vaccine in two rounds, four weeks apart, to prevent the disease from spreading.

Israel and Hamas have agreed to eight-hour daily pauses in fighting for at least three days, starting from Sunday, to facilitate the first round of vaccinations at 160 sites. The programme has begun in central Gaza, where around 1 million people are sheltering after fleeing their homes.

Airstrikes and ground fighting continued in some areas of Gaza on Sunday. The health ministry reported that hospitals had received 89 dead and 205 wounded in the last 24 hours – one of the highest daily casualty tallies in months. Residents said Israeli troops blew up several houses in Rafah, near the border with Egypt, while tanks continued to operate in the northern Gaza City suburb of Zeitoun.

Damaged roads and medical infrastructure are also major issues for the transportation and cool storage of vaccines.

Israel allowed about 1.3m doses to be brought into Gaza last month, which are now being held in refrigerated storage in a warehouse in Deir al-Balah. Another shipment of 400,000 doses is to be delivered to the territory soon.

On Sunday, the Guardian saw hundreds of families queue at schools and other vaccination centres in Deir al-Balah to inoculate their children on the first full day of the rollout. At one centre, two tables of healthcare workers worked in groups of three; one administered a dose, another held the child, and a third filled out a form and marked a finger on the vaccinated children’s left hands with ink.

Vaccine hesitancy is another problem to overcome, according to several residents. “At first, I was afraid because of rumours that [the vaccine was experimental], especially since it came from Israel, so at the beginning I did not accept the idea. But I was reassured by the Ministry of Health and decided to go,” said Nour Al-Shabrawi, a 30-year-old mother of three. The family, like 90% of Gaza’s 2.3m population, has been displaced several times.

“The children have already suffered a lot after contracting skin pimples and infectious diseases such as hepatitis,” she said, adding that the family’s biggest problem other than food was a lack of soap, shampoo and water to keep clean.

In a video released by the WHO on Sunday, a technical officer, Deepak Kumar, said that Sunday’s vaccination drive had gone well in the communities the teams visited in Deir al-Balah and nearby Nuseirat.

“The families and children are coming and they’re really excited to receive the vaccination … So, it’s very encouraging that the start of the campaign is quite positive,” he said.

Most people who have polio do not experience symptoms, and those who do usually recover in a week or so. But there is no cure, and when polio causes paralysis, it is usually permanent. If the paralysis affects the breathing muscles, it can be fatal.

Ammar Ammar, a spokesperson for the UN children’s agency, said it hoped both parties would adhere to the temporary truce in designated areas to enable families to reach health facilities, but called for a return to stalled talks aimed at a lasting ceasefire.

“This is a first step,” he said. “But there is no alternative to a ceasefire because it’s not only polio that threatens children in Gaza, but also other factors, including malnutrition and the inhuman conditions they are living in.”