Mass vaccination campaigns for polio eradication: an essential strategy for success

Effective vaccines against poliomyelitis became available in the mid-1950s and early 1960s. Mass campaigns were an integral part of early control efforts. Thereafter, polio vaccines were used largely in routine childhood programs. The resolution in 1988 to eradicate polio globally led to the development of appropriate strategies to achieve this goal, including mass vaccination campaigns (i.e., national immunization days, sub-national immunization days and mop-up activities), to achieve the highest possible coverage in the shortest possible time. Unlike other vaccines, mass campaign use of oral poliovirus vaccine enhances the immunogenicity of this vaccine, primarily due to: (1) the decrease in the prevalence of other enteroviruses that potentially interfere with seroconversion; and (2) the secondary spread of vaccine virus from vaccinees to close contacts, resulting in seroconversion of some unvaccinated contacts. To reach the highest possible coverage, detailed planning, meticulous execution, careful supervision and standardized monitoring are critical. A number of innovative approaches to improve the quality and/or coverage have become the 'standard' of supplemental immunization activities. These mass campaigns have led to dramatic decreases in the incidence of polio. This chapter reviews the scientific, operational and programmatic data on mass campaign use of polio vaccines, and summarize the lessons learnt from implementing the mass vaccination strategies used to eradicate poliomyelitis globally.