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 Table of Contents 
Year : 1997  |  Volume : 4  |  Issue : 1  |  Page : 53-56  

The second campaign for poliomyelitis vaccination in the eastern province: Different strategy with similar success

1 Department of Neurology, King Fahd Hospital of the University, Al-Khobar, Saudi Arabia
2 Department of FAMCO, King Fahd Hospital of the University, Al-Khobar, Saudi Arabia
3 Ministry of Health, Riyadh, Saudi Arabia
4 Directorate of Health, Eastern Province, Saudi Arabia

Date of Web Publication31-Jul-2012

Correspondence Address:
Abdulsalam A Al-Sulaiman
Associate Professor & Chairman, Department of Neurology, King Fahd Hospital of the University, P.O. Box 40180, Al-Khobar 31952
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

PMID: 23008566

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Purpose: To determine whether the change from the door-to-door strategy of administering the Oral Polio Vaccine (OPV) to designated vaccination points has led to less than optimal vaccination coverage.
Methods : The Second Bi Annual Poliomyelitis Vaccination ended on 28 Rajab 1417N (9 December 1996G). To minimize the high cost in terms of staff and fi­nancial resources, the local authority in the Eastern Province offered the vacci­nations at various primary health and commercial centers, schools and private hospitals. The WHO cluster sampling technique was used to conduct a survey in the Al-Khobar and Qatif areas to verify the percentage coverage using the new strategy.
Results : A total population of 1399 including 644 adults and 755 children (317 Al-Khobar, 438 Qatif) was surveyed. There were 153 children aged less than 5 years in Al-Khobar and 179 in Qatif Of these, 148 (96.7%) in Al-Khobar were vaccinated compared to 179 (100%) in Qatif. Only 5 of the eligible children were not vaccinated, two of whom were Saudis and three non-Saudis.
Conclusions : The study shows an overall percentage coverage of 98.4 in the Eastern Province which is well above the WHO's minimal 80% target for success. This method of vaccination at assigned points may be used in areas where the lit­eracy rate is high and public cooperation is at a maximum.

Keywords: Poliomyelitis, campaign, vaccination, Saudi Arabia

How to cite this article:
Al-Sulaiman AA, Al-Mazrou YY, Al-Bar AA, Al-Ali AA. The second campaign for poliomyelitis vaccination in the eastern province: Different strategy with similar success. J Fam Community Med 1997;4:53-6

How to cite this URL:
Al-Sulaiman AA, Al-Mazrou YY, Al-Bar AA, Al-Ali AA. The second campaign for poliomyelitis vaccination in the eastern province: Different strategy with similar success. J Fam Community Med [serial online] 1997 [cited 2021 Sep 27];4:53-6. Available from:

   Introduction Top

The World Health Organization (WHO) established the elimination of poliomyelitis from the world as a goal. [1] The strategies have been clearly outlined as follows: (1) establishment and maintenance of high routine vaccination coverage with oral po­lio vaccine; (2) development of poliomyeli­tis surveillance and reporting systems; (3) establishment of national immunization days for children under five years of age; (4) "mopping-up" vaccination campaigns targeting high-risk areas where wild polio virus transmission is most likely to per­sist. [1]-[4] The Kingdom of Saudi Arabia (KSA) has adopted the WHO's program, applying the first 3 steps. First, the King­dom has established and maintained rou­tine immunization coverage. Secondly, case surveillance and identification has been done. The first national immunization during assigned days was successful in achieving more than 80% vaccination for all children aged 5 years and less. In this campaign, immunization was given by trained health workers administering the vaccine on a door-to-door basis. The cost was high in terms of staff and financial resources. In an attempt to minimize the financial and staff burden, the local authorities in the Eastern Province of Saudi Arabia decided to change the strategies of the national immunization days. Instead of administering the oral polio vaccine from door-to-door, the vaccine was supplied at designated points throughout the region. These designated points included various health, educational and commercial cen­ters. The general public awareness was heightened by the use of the mass media. On the eve of the national immunization days, the campaign was inaugurated by royal dignitaries. The second period of immunization started on 26 Rajab 1417H (7 December 1996) and concluded on 28 Rajab 1417H (9 December 1996). The aim of the present study was to verify whether the change in the door-to-door vaccination policy led to a less than optimal immuni­zation coverage.

   Material and Methods Top

The standard WHO cluster technique was employed for sampling [5] The randomly selected clusters of households were chosen from the Al-Khobar and Qatif areas. Each of these two cities was divided into ho­mogenous sectors. A total of 30 clusters were selected, 15 from Al-Khobar and 15 from Qatif. All Saudi and non-Saudi resi­dents in these households were screened using a pre-tested questionnaire in a face-­to-face interview by trained professionals. [6] The questionnaire included information on the number of children in the household, the total number of children vaccinated in the national poliomyelitis vaccination cam­paign, the total number of non-vaccinated children and the reasons for non­vaccination. To ensure support and coop­eration, earlier contacts with government and Ministry of Health (MOH) institutions were made and individual wishes were re­spected throughout the survey.

   Results Top

A total of 307 households (Al-Khobar 154 and Qatif 153) with the total population of 1399 including 644 adults and 755 chil­dren (317 in Al-Khobar and 438 in Qatif) were surveyed. The children aged less than 5 years in Al-Khobar were 153 and 179 in Qatif. Twenty-five households in Al­-Khobar and 10 households in Qatif had no children. Of the targeted population (children less than 5 years of age), 148 (97.1%) were vaccinated compared to 179 (100%) in Qatif. All the vaccinated chil­dren received their vaccinations at the pri­mary health care centers, private hospitals or at school. In Al-Khobar 5 (3.3%) of the targeted population did not receive vacci­nations. Two of the 5 eligible children who were not vaccinated were Saudis and 3 were non-Saudis. The nationalities sur­veyed in Al-Khobar and Qatif are shown in [Table 1].
Table 1: Frequency of nationalities surveyed in Al-Khobar and Qatif

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   Discussion Top

The pledge to eradicate poliomyelitis from the globe by the year 2000 is steadily pro­gressing under the directives of the WHO. The incidence of poliomyelitis infection is decreasing worldwide. [7],[8],[9],[10],[11] Some parts of the world have successfully eradicated polio­myelitis [12] and the KSA has established several positive milestones to that end. The newly established case identification and surveillance by the MOH shows a de­cline in the incidence of poliomyelitis. This was most probably due to the early national vaccination campaign held in Jumada and Rajab of 1416H (November 1995). For various reasons, particularly relating to staff and financial constraints, a different strategy was adopted for the sec­ond national vaccination campaign. Distri­bution points for vaccination were estab­lished in the community and the public was encouraged to go to these points. This strategy was used only in the Eastern Province. Following the vaccination days a quality assurance survey using a question­naire was conducted by trained profession­als. The results showed an overall coverage of 98.4% in the Eastern Region (Al-Khobar 96.7% and Qatif 100.0%). The reasons for non-vaccination were mainly the lack of knowledge of the changed strategy and ig­norance of what was happening. These problems can be rectified through mass media education and better publicity of the new strategy.

The WHO stipulates that a minimum of 80% vaccination coverage of the target population is needed for successful vacci­nation campaigns. In Al-Khobar, the cam­paign achieved 96.7% coverage. This lower-than-expected coverage in Al­-Khobar is still well above the 80% target of the WHO's expectations.

The method of vaccination through distribution points on the national vaccina­tion days, rather than door-to-door vacci­nation, is relatively new to the KSA. It may be used in areas where the literacy rate is high and public cooperation is maximal. This has been shown to be successful in the present study. The Ministry of Health con­tinues to make positive strides towards the achievement of the noble goal of eradicat­ing poliomyelitis from the Kingdom.

   References Top

1.World Health Organization. Global poliomyelitis eradication by the year 2000-plan of action. Ge­neva: World Health Organization, 1992.  Back to cited text no. 1
2.World Health Organization. Report of the first meeting of the global commission for certification of the eradication of poliomyelitis. Geneva: World Health Organization, 1995.10.  Back to cited text no. 2
3.Hull HF, Ward NA, Hull BP, Milstine JB, de Quadors CA. Paralytic poliomyelitis: Seasoned strategies, disappearing disease. Lancet 1994;11:343:1331-7.   Back to cited text no. 3
4.Cochi FL, Hull HF, Ward NA. To conquer polio­myelitis forever. Lancet 1995; 345:1589-90.  Back to cited text no. 4
5.Henderson RH, Sundaresan T. Cluster sampling to assess immunization coverage: A review of ex­perience with a simplified sampling method. Bull World Health Organization 1982; 60:253-60.   Back to cited text no. 5
6.Al-Sulaiman A, Al-Mazrou Y, Al-Bar A. Did the national campaign for poliomyelitis vaccination achieve its objectives? A pilot survey in Al-Khobar area. J of Family & Community Med 1996; 3(2):77-80.  Back to cited text no. 6
7.Patriarca PA, Foege WH, Swartz TA. Progress in polio eradication. Lancet 1993; 342:1461-4.   Back to cited text no. 7
8.Anonymous. Progress toward global poliomyelitis eradication 1985-1994. MMWR 1995; 44:273­-81.  Back to cited text no. 8
9.Anonymous. Expanded programme on immuniza­tion. Progress towards poliomyelitis. Weekly Epidemiological Record 1995; 70:97-101.  Back to cited text no. 9
10.Cochi SL, Orenstein WA. Commentary: China's giant step toward the global eradication of polio­myelitis. Pediatr Infect Dis J 1995; 14:315-16.   Back to cited text no. 10
11.Yang B, Zhang J, Often MW Jr, Kusumoto K, Jiang T, Zhang R, et al. Eradication of poliomye­litis: progress in the People's Republic of China. Pediatr Infect Dis J 1995; 14:308-14.   Back to cited text no. 11
12.Pay. American Health Organization. Strategies for the certification of the eradication of wild poliovirus transmission in the Americas. Bull Pan Am Health Organ 1993; 27:287-96.  Back to cited text no. 12


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