Using Inactivated Polio Vaccine Vaccination Campaign Coverage Insights to Strengthen Nepal's Immunization Programme

Background Nepal's National Immunization Programme (NIP) has made significant strides in safeguarding public health, notably through the integration of the Inactivated Polio Vaccine (IPV) in national immunization schedule, in 2014, to combat wild poliovirus serotypes. However, a global IPV shortage between 2016 and 2018 left approximately 1.46 million children unvaccinated, creating an immunity gap against Type-2 poliovirus. Objective To evaluate the coverage and equity of Nepal's national inactivated polio vaccine catch-up campaign (May 26 to June 8, 2024) and identify key areas needing improvement. Method Administrative data from all 77 districts were reviewed and analysed by province, district, and ecological zone. To address this, Nepal launched a nationwide IPV vaccination campaign from May 26 to June 8, 2024, targeting children aged between five years and eight months to eight years and months. Result The campaign achieved national coverage of 95.9%. However, disparities were noted: district-level coverage ranged from 45.2% in Bagmati to 124.7% in Koshi. Province-level performance varied, with Madhesh (111.6%) and Karnali (110.7%) exceeding targets, while Bagmati (88.2%) and Gandaki (75.8%) underperformed. These differences were influenced by terrain, cold chain capacity, population mobility, and urban-rural inequities. Conclusion Nepal's inactivated polio vaccine campaign largely succeeded in bridging the post-shortage immunity gap, but subnational disparities highlight systemic challenges. Strengthening cold chain infrastructure, improving microplanning through quality data, and tailoring outreach to underserved areas are essential to enhance equity and sustain Nepal's polio-free status.