Health Ministry expanding public polio vaccination campaign in Israel's south

The Health Ministry will embark on a polio inoculation campaign, it announced at the end of last week. The number of children to be inoculated is to be announced Sunday, but the figure so far under consideration is 150,000–200,000 children in the south up to nine and a half years old.

The campaign comes in response to a spread of the virus, first detected in May in the sewage system in the Negev town of Rahat, and subsequently elsewhere in the south and in communities in the Sharon area.

The decision was made after consultation with experts over the past few days, and due to concerns of health authorities in Europe of a spread of the polio virus from Israel to abroad. Representatives of the World Health Organization reportedly told Health Ministry officials at the end of the week that they support the campaign.

The children are to be inoculated with the same vaccine given in well-baby (Tipat Halav) clinics, which contains a weakened form of the virus. The goal is for this weakened form of the virus to be passed on to the people in the children’s immediate surroundings, thereby immunizing those who have not been inoculated in the past.

The decision to inoculate the children involves an ethical dilemma because the children themselves don’t need the inoculation – 94 percent to 96 percent were inoculated with the killed virus as part of the national inoculation program in well-baby clinics and schools (at six months, 1, 2, 4 and 6 years of age, and in the second grade). The downside of the program is that the weakened form of the virus, while intended to protect previously unvaccinated people, poses a risk that they may actually contract the disease.

Campaign to last 60 days

Over the past few weeks the Health Ministry has ordered about half a million doses of the vaccine containing the weakened virus, at a cost of NIS 500,000. So far, about 200,000 doses have arrived, and will be distributed today at well-baby clinics. The vaccine contains two strains of the weakened virus. Type 1 is the strain discovered in the sewage system and another strain, Type 3. Type 2, which was included in the weakened-virus inoculations given in Israel until 2005, is now believed to be extinct worldwide, and removing it from the vaccine is said to lower the risk of side effects and increase the vaccine’s efficacy.

The campaign is scheduled to last 60 days, during which well-baby clinics will work extended hours. Children from age 6 will also be able to receive their inoculation at school after the school year begins.

The danger of contracting polio following a vaccination campaign with the weakened virus is greater among people whose immune system is weak, including the severely ill. Among the children receiving the vaccine, the chance of contracting the disease is almost nil. According to the medical literature, only once case is known of a child who was first inoculated with dead virus, and subsequently inoculated with weakened virus, and then was inoculated with the weakened virus.

The Health Ministry is continuing to collect stool samples from residents of the south in a survey to assess the spread of the virus through the sewage system. So far, the survey has identified a number of Israelis carrying the polio virus, which shows that it is spreading. However, no one has been identified as having contracted polio since the last outbreak in Israel in 1988. At that time, 15 people contracted polio and became paralyzed, most of them from the area between Hadera and Or Akiva.

At the end of May, the polio virus was detected in the sewage system in Rahat, and then it spread to a number of other communities in the south, including Be’er Sheva and Ashdod. A Health Ministry investigation showed that the virus has been present since February 2013. In July the virus was found in the sewage system in Ramle, Lod, Modi’in and communities in the Sharon area. The Health Ministry believes that the virus came from Egypt.

There are only five countries worldwide where people have been diagnosed with polio. In three of these, the disease is considered endemic, and is spreading uncontrolled: Afghanistan, Pakistan and Nigeria. The other two countries, in which a few people with the disease have been found this year, are Somalia and Kenya.