India is vaccinating everyone arriving from Afghanistan against polio, which has been eradicated in India but continues to infect children in Afghanistan and Pakistan.
India reported its last case of polio on 13 January 2011. Since then, the country has sustained its polio-free status by maintaining high population immunity through the administration of oral polio vaccine (OPV) and inactivated poliovirus vaccine (IPV)
as part of routine immunisation along with supplementary immunisation activities, global-quality surveillance for all cases of acute flaccid paralysis (a symptom of polio), expanding environmental surveillance, and vaccinating travellers to and from
polio endemic and high-risk countries.
Afghanistan and Pakistan continue to remain endemic for polio, with high transmission of wild polio virus (WPV) and circulating Vaccine Derived Polio Viruses - 2 (cVDPVs). In the past 12 months, Afghanistan reported 11 wild polio cases and 261 circulating VDPV-2 cases, as on 27 August 21. The migration of Afghan nationals and the evacuation of Indian citizens from Afghanistan has enhanced the risk for the importation of wild poliovirus or vaccine-derived polioviruses into the country.
To mitigate this risk, India is vaccinating all travellers from Afghanistan with OPV and one fractional dose of IPV (fIPV) upon arrival.
Following an alert from the Ministry of Health and Family Welfare of the arrival of flights from Afghanistan to Delhi on 20 August 2021, the Delhi state government constituted multi-department teams to vaccinate passengers with OPV and IPV at the airport with support from WHO-National Public Health Support Programme (NPSP).
The flights arrived on the morning of 22 August 2021 with 258 passengers, who were administered fIPV and OPV, and finger-marked following vaccination. The passengers were also tested for Covid-19 using RT-PCR tests.
The roles and responsibilities of the teams were clearly defined. The director of family welfare with Delhi government and the state immunisation officer provided the necessary guidance, coordination and oversight; the officials from Airport Health Office registered the travellers and facilitated vaccination and Covid-19 RT-PCR testing; and GMR Group and Central Industrial Security Force (CISF) helped to organise the sessions and manage the crowd. Delhi government health workers administered the vaccines, and the WHO NPSP team supported arranging for the vaccines, coordination of the on-site activities - including answering queries to address vaccine hesitancy among passengers - and finger-marking those who had been vaccinated to ensure no one was missed.
The WHO NPSP team also provided on-the-job training to vaccination staff who had not administered the polio vaccines before. The seamless rollout of polio and COVID-19 vaccination at Delhi Airport underscored the importance of close collaboration with state governments and all stakeholders and the deployment of a number of trained teams, with a medical officer, vaccinators and other support members, supervisors and monitors, and CISF for crowd management.