Has COVID-19 influenced parental perceptions and knowledge about polio vaccination in Pakistan?

Despite global vaccination efforts, Pakistan remains one of the last 2 countries where wild poliovirus is still endemic.

To assess the change in parental knowledge and perceptions about polio vaccination after COVID-19 pandemic.

From January to April 2025 we interviewed 308 parents, who were permanent residents for ≥2 months, with at least one child aged 0-5 years and willing to provide informed consent, in 4 administrative subdivisions of North Waziristan District, Pakistan. We analysed the data using SPSS version 22 and used McNemar's test to assess changes in perceptions.

Average short answer knowledge score increased from 6.2 ± 2.3 pre-COVID-19 to 8.3 ± 2.1 post-COVID-19, resulting in overall significantly better knowledge of polio vaccination (P < 0.0001). Good knowledge (mean score ≥ 9) increased from 36.3% to 58.7%, knowledge of the viral etiology increased from 50.0% to 71.4%, and misconceptions decreased from 64.9% to 35.1%. Recommendations by health care providers (85%), social media campaigns (76%) and advocacy by religious leaders (55%) contributed to the improvement in knowledge.

Parental knowledge increased, with more positive attitude towards polio vaccination, due to the COVID-19 pandemic. Building on this, further improvements can be achieved through strategic community engagement with health workers, religious leaders and social media, towards overcoming vaccine hesitancy and achieving polio eradication.