By Omoyeni Ojeifo
Despite administering over 450 million novel oral polio vaccine (nOPV2) doses during outbreak responses, Nigeria has yet to halt poliovirus transmission, public health specialist Dr. Kabir S. Mashi warned.
In an exclusive interview with PerSecondNews marking World Polio Day (October 24), Dr. Mashi blamed lingering gaps in routine immunization, compromised campaign quality, weak surveillance, and vaccine hesitancy for the virus’s persistence.
He called on government and public health authorities to upgrade campaign standards and reinforce routine childhood immunization to eliminate the threat once and for all.
Low Immunisation Coverage Leaves Children Vulnerable
Mashi identified low routine immunisation coverage, particularly in northern Nigeria, as a major factor sustaining poliovirus transmission.
According to him, routine immunisation coverage remained low in northern Nigeria, with fewer than half of eligible children receiving the third dose of the oral polio vaccine in most northern states.
In Sokoto State, coverage was approximately 16 per cent, according to figures he provided.
“The immunity gap leaves too many children vulnerable to infection. Vaccination campaigns cannot permanently compensate for weak routine immunisation services,” he said.
Mashi added that more than one million zero-dose children were projected to be in the North-West, making it essential to identify and reach children who had not received routine vaccines.
Surveillance Gaps Hide Poliovirus Transmission
The public health expert said weaknesses in disease surveillance allowed poliovirus to circulate undetected in some communities.
He cited data indicating that 43 per cent of polioviruses detected in 2026 were classified as genetic orphans, suggesting that surveillance had failed to identify the transmission chains from which they originated.
“When we detect a genetic orphan, it raises questions about where the virus has been circulating and why our surveillance system did not identify it earlier,” he stated.
Mashi explained that insecurity, inaccessible settlements and population movement could prevent health workers from reaching communities and detecting infections promptly.
Poor Campaign Quality Undermines Progress
Mashi warned that the number of vaccination rounds conducted would not necessarily translate into protection if the campaigns were poorly implemented.
He identified fake finger-marking, data falsification, political interference and community resistance as factors undermining vaccination activities.
“Campaign quality is as important as the number of doses administered. A child who is recorded as vaccinated but has not received the vaccine remains unprotected,” he told PerSecondNews.
Account to him, efforts to resolve vaccine non-compliance succeeded in approximately 58 per cent of cases, highlighting the need for stronger engagement with resistant households and communities.
Millions Of Doses Have Not Ended Transmission
Mashi explained that the administration of more than 450 million doses of nOPV2 had not eliminated transmission, demonstrating that vaccination numbers alone were insufficient to measure programme success.
He explained that the reported per-dose effectiveness in outbreak-response settings was approximately 12 per cent, making repeated, high-quality vaccination rounds and strong routine immunisation particularly important.
“High vaccination numbers are not enough if the children and communities most at risk are missed. Every round must reach its intended population and achieve the required quality,” he said.
He urged the government and vaccination partners to improve campaign planning, monitoring and follow up in communities where poliovirus continued to circulate.
Polio Can Cause Lifelong Disability
The expert warned that polio could cause permanent paralysis, physical deformities and long-term complications, particularly among children who lacked timely access to rehabilitation.
He said approximately one to two per cent of polio infections resulted in permanent paralysis, while between two and five per cent of paralytic cases could be fatal. The fatality rate could reach 10 per cent during epidemics.
“Polio is not simply an infection that passes through the body. For children who develop paralysis, the consequences can affect movement, education, independence and their ability to participate fully in society,” he stressed.
Mashi added that survivors could develop post-polio syndrome decades after the initial infection, with an estimated 20 to 40 per cent experiencing new muscle weakness, pain or fatigue.
According to him, affected children and adults could also experience muscle wasting, limb shortening, clubfoot and spinal deformities, particularly where braces, physiotherapy and rehabilitation services were unavailable.
Traditional Leaders And Parents Have A Role
Mashi said vaccination teams needed to build trust with families and address social and cultural barriers that prevented children from receiving vaccines.
He recommended deploying more female vaccinators and involving traditional leaders in selecting vaccination teams, citing programme figures suggesting coverage growth of 18 per cent in settings where traditional leaders were involved, compared with five per cent elsewhere.
“Traditional and religious leaders can help explain the benefits of vaccination and encourage families to accept health workers. Their involvement can make a difference in communities where mistrust remains a challenge,” he said.
He added that fathers’ consent requirements and gender-related barriers could limit access to children, making it important for health workers to engage both parents and understand the circumstances of each household.
Government Must Strengthen Routine Immunisation
Mashi urged the government to integrate polio interventions more effectively into primary healthcare services and increase domestic funding for immunisation through mechanisms such as the Basic Health Care Provision Fund.
He suggested that an independent review of surveillance was also necessary to assess community informant networks, environmental surveillance and the inclusion of mobile populations and communities affected by insecurity.
“Polio response must not depend on campaigns alone. Nigeria needs a stronger primary healthcare system, reliable surveillance and the capacity to respond quickly whenever transmission is detected,” the expert maintained.
Mashi also recommended a house-to-house approach dubbed “Operation Show Me Your Child Health Card” to help identify zero-dose children and establish whether eligible children had received their routine vaccinations.
He emphasized that Nigeria needed to shift from focusing solely on eradication campaigns to sustained risk management through strong routine immunisation, continuous surveillance and rapid responses to outbreaks.
Nigeria was declared free of wild poliovirus by the World Health Organization on August 25, 2020, after more than three years without a detected case.
The last reported case of wild poliovirus in the country was recorded in Borno State in August 2016.
However, Nigeria continues to record outbreaks of vaccine-derived poliovirus, which can spread in communities where vaccination coverage is low and cause paralysis in unprotected children.
World Polio Day is an annual observance held on October 24 to raise awareness about polio and renew global efforts to eradicate the disease.
This year’s theme is “One Day. One Focus: Ending Polio.”
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