Polio was almost eradicated. Then came the coronavirus. Then came a threat from President Trump. (Barf)

For decades, the United States has worked with the World Health Organization and others to quash polio, beating back to near extinction a merciless disease that once paralyzed hundreds of thousands of children each year.

That progress is in danger as the pandemic forces health-care providers to suspend door-to-door vaccination campaigns that have slashed the number of infections.

New cases have emerged in Niger and Chad, and fears have mounted about a resurgence in Afghanistan and Pakistan. Although the number of new polio infections has been small — 155 confirmed cases since January — even blips are worrisome, public health experts say, because small increases can trigger explosive outbreaks, especially in poor countries without the resources to combat the virus alone.

“The polio virus is being let free,” said Abdul Qadir, a health worker who has spent the past eight years delivering the vaccine in western Pakistan.

not a hint in the following that the State Governors are to blame:

23 Apr: NYT: Vaccine Rates Drop Dangerously as Parents Avoid Doctor’s Visits
Afraid of Covid-19, parents are postponing well-child checkups, including shots, putting millions of children at risk of exposure to preventable deadly diseases.
By Jan Hoffman
PCC, a pediatric electronic health records company, gathered vaccine information from 1,000 independent pediatricians nationwide. Using the week of February 16 as a pre-coronavirus baseline, PCC found that during the week of April 5, the administration of measles, mumps and rubella shots dropped by 50 percent; diphtheria and whooping cough shots by 42 percent; and HPV vaccines by 73 percent...

Though many doctors note that vaccine-preventable diseases can be more deadly to children than Covid-19 seems to be, parents are understandably focused on the threat at hand. Over the last six weeks, the loud, consistent public message has been to keep children at home, and to take them to the doctor only if necessary...

In the early weeks of the shelter-in-place orders, doctors concentrated efforts on vaccinating infants up to 2 years old, and waved off the disruption to the schedule for older children as temporary, saying it could readily be addressed once the restrictions lifted. But the longer that the orders continue, the more worried doctors have also become about vaccine protection for older children...
Many doctors already report that the backlog from canceled appointments for younger children is staggering...
https://www.nytimes.com/2020/04/23/health/coronavirus-measles-vaccines.html

What the paywall Wash. post is mostly likely not telling its readers (and I am not anti-vacc):

Polio outbreaks in Africa caused by mutation of strain in vaccine. Edna Mohamed. Published on Thu 28 Nov 2019

New cases of polio linked to the oral vaccine have been reported in four African countries and more children are now being paralysed by vaccine-derived viruses than those infected by viruses in the wild, according to global health numbers. The World Health Organization (WHO) and partners identified nine new cases caused by the vaccine in Nigeria, the Democratic Republic of the Congo, Central African Republic and Angola last week. Along with seven other African countries with outbreaks, cases have also been reported in Asia. In Afghanistan and Pakistan polio remains endemic, and in Pakistan officials have been accused of covering up vaccine-related cases.

In developing countries the oral vaccine is used due to its low cost and accessibility, needing only two drops per dose. In western countries, a more expensive, injectable version of the vaccine – which contains an inactivated virus incapable of causing the disease – is used as a preventative.

The onset has been caused by a type 2 virus contained in the vaccine. Type 2 is a wild virus that was eliminated years ago, but in rare cases the live virus in oral polio vaccines can mutate into a form capable of igniting new outbreaks of the disease. (https://www.theguardian.com/global-development/2019/nov/28/polio-outbreaks-in-four-african-countries-caused-by-mutation-of-strain-in-vaccine)

Polio Is Making A Comeback. NPR. Jason Beaubien, November 15, 20195:04 PM ET

One of the biggest obstacles this year is the proliferation of so-called "vaccine-derived" polio outbreaks.

Conventional polio caused by the traditional form of the disease is now only occurring in two countries in the world — Afghanistan and Pakistan. The World Health Organization calls this form "wild" polio and there've been roughly 100 cases so far this year. This is a tiny number compared to the 350,000 cases that occurred globally before the Global Polio Eradication Initiative was launched in 1988.

But what's troubling now is that there are currently more kids being paralyzed by cases of vaccine-derived polio than by the original "wild" variety. ..Currently around the world, all children are supposed to get vaccinated against polio. In the U.S. and other wealthy nations, kids get 4 injections of inactivated polio vaccine spread out over their first 7 years of life. This injectable vaccine does not contain live virus, so it does not and cannot cause vaccine-derived polio. In lower income countries with weaker health systems, an oral vaccine containing a live but weakened version of the polio virus is used. It's cheap and easy to administer through a few drops in a child's mouth.

In the early days of polio eradication, this live oral vaccine also had the added benefit that it could circulate in a community just like the real, wild virus. In places with poor sanitation, wild polio and the virus in the oral vaccine can spread from sewage to drinking water. At first this was great. Kids who hadn't been vaccinated by health workers ended up getting exposed to the oral vaccine and protected against wild polio because of their lousy drinking water supplies. But over time the virus from the oral vaccine starts to regain strength and if it's allowed to circulate long enough, it reverts back to the point that it can cause paralysis just like the original virus...

One way to get off that treadmill would be to get rid of the live oral vaccine and switch to the not-live, injectable vaccine used in the United States. The Global Polio Eradication Initiative has tried to move in that direction but there are several challenges. First there just isn't enough supply globally of the injectable vaccine to cover the hundreds of millions of kids in low income countries. Training vaccinators to give injections is much harder than training them to give two drops in to a child's mouth...

There are three distinct strains of polio and each strain requires a different vaccine to prevent against it. In 2015, the WHO declared Type-2 wild polio eradicated. But the problem was that the oral polio vaccine still contained live weakened Type-2 virus and while the wild Type-2 was gone, occasionally there continued to be outbreaks of vaccine-derived Type-2 polio.

In 2015, the WHO declared Type-2 wild polio eradicated. But the problem was that the oral polio vaccine still contained live weakened Type-2 virus and while the wild Type-2 was gone, occasionally there continued to be outbreaks of vaccine-derived Type-2 polio.

So the Global Polio Eradication Initiative orchestrated a maneuver that insiders call the "switch". In April 2016, everywhere around the world the old oral polio vaccine that contained all three strains of the virus were to be pulled out of circulation and replaced with a new vaccine. The new oral vaccine would only contain virus to protect against types 1 and 3. Health officials expected that some rogue Type-2 viruses would pop up and they had plans to quickly attack any Type-2 outbreaks that might occur. But they also expected that Type-2 vaccine-derived polio would die out relatively quickly.

"It was it was a bold move," says Noymer, who studies the history of outbreaks. "It was a sign of incredible progress. But it was a gamble and it didn't pay off."

Now, three years after Type-2 polio was declared eradicated, the most problematic form of polio is vaccine derived Type-2.

That's because in order to respond to those predicted vaccine-derived Type-2 outbreaks, health officials inoculate kids near the outbreak with a specially stockpiled vaccine that protects only against Type-2. But there can be spillover from these mop-up campaigns, which gives the virus another chance to get into the environment, circulate and regain strength in communities. People who were never immunized end up getting exposed, sparking another outbreak. - https://www.npr.org/sections/goatsandsoda/2019/11/15/779865471/polio-vaccine-may-be-preventing-the-end-of-polio

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