Fighting in Gaza limits vaccine access in ‘dangerous’ polio red zones

Health workers will not send vaccine teams into outbreak hotspots unless their safety can be guaranteed

Health workers in Gaza are concerned polio vaccines won’t reach the north of the enclave because of ongoing fighting.
The United Nations and World Health Organization (WHO) launched the second round of a polio vaccination campaign in Gaza on Monday, targeting 590,000 children under the age of 10.
It follows an outbreak of the crippling disease in the enclave which was first detected in July.
“We are concerned about the north because of the repeated evacuation orders, including for the hospitals and populations around that,” said Rik Peeperkorn, the WHO’s representative in the Palestinian territories.
“We cannot afford to falter in the second round. We need to stop this transmission of the poliovirus.”
Mahmoud Shalabi, Deputy Director of Programmes at Medical Aid for Palestinian’s (MAP), said that he is “still unsure” if the polio campaign will be able to go ahead in northern Gaza, adding that he will “not send [his] colleagues to red zones, as it is too dangerous”.
“We need a ceasefire and assurances that humanitarian workers will not be targeted,” he told The Telegraph. “This is more important than just the polio vaccination right now.”
Senior Deputy Director of UNRWA Affairs in Gaza, Sam Rose, added that the continued siege in the north “risks jeopardising the success of the overall campaign.”
“If we’re not able to get [into] the north, then there could be real clusters of children that aren’t vaccinated,” he told The Telegraph. “That causes real problems for the immunity of the population as a whole.”
The second round of the vaccination campaign comes as Israel faces mounting pressure from the Biden Administration to improve the humanitarian situation in the besieged enclave.
A joint letter penned by Antony Blinken, the US secretary of state, and Lloyd Austin, the defence secretary, on Tuesday warned Israel that it faces punishment, including the potential stopping of US weapons transfer, if it doesn’t take immediate action to allow more humanitarian aid into Gaza.
The vaccination campaign was launched in July after a 10-month-old baby became the first person to be infected with polio, which can cause paralysis and death in young children, in the territory in 25 years.
Immunisation rates in Gaza and the occupied West Bank were optimal before October 7 but fell from 99 per cent in 2022 to less than 90 per cent in the first quarter of 2024, according to the latest WHO data.
A minimum of two doses of nOPV2 are needed to interrupt poliovirus transmission, but this will only be achieved if at least 90 per cent of all eligible children are vaccinated.
In this round, vitamin A will be co-administered orally along the polio vaccine, to help boost overall immunity among children.
Where the first dose provides some immunity, Mr Rose warned there’s a risk that the current polio strain could “mutate” into a “new variant” if the disease continues to spread between children who haven’t received both doses of the vaccine.
“The likelihood of this happening is higher in an environment where children are malnourished and have weakened immune systems,” he said.
Although only one case of polio has been reported, at least six wastewater samples came back positive for traces of the virus in July, meaning it is probably circulating more widely.
“There is an increased risk that environmental samples will remain positive if we are not able to reach these children, and a risk that this will not be confined to Gaza,” said Mr Rose.
“Palestinians aren’t the only ones that are coming into contact with that water, Israeli soldiers are as well.”
As with the initial round of vaccinations last month, the second will be divided into three phases, with short six hour “humanitarian pauses” in the fighting. The campaign began in central Gaza, then travelled to the south and finally, in the hardest to reach north of the territory.
Each phase is planned to take three campaign days, along with one catch-up day for monitoring and reaching any children who were missed.
But many Palestinians fear it is too dangerous to travel to vaccination sites.
Displaced with thousands in Deir al-Balah city, Raed Baroud, 32, said that any kind of movement is considered “a risk [to their] lives”.
“Life has become different now. Moving is dangerous. No one knows where the bombing will take place, whether I am in a safe place or not,” he told The Telegraph.
Dr Khalil Al-Daqran, spokesman for Al-Aqsa Martyrs Hospital, added that there was “fear and anxiety” among the Palestinians.
“Despite the spread of vaccination centres everywhere, this does not mean that citizens can reach them,” he told The Telegraph.
It comes after a volley of Israeli artillery ignited a lethal fire that ripped through a tent camp at Al-Aqsa hospital in Deir al-Balah, central Gaza, in the early hours of Monday, just hours before the start of the second phase of the vaccination rollout in the middle region.
An image of a person burning alive among the ravaged tents was shared widely on social media. At least four people were killed and dozens injured, mostly women and children, according to the Hamas-controlled health ministry.
With the near-total destruction of many of Gaza’s streets causing transport costs to rocket, paired with fear of being bombed, many displaced families have been forced to rely on vaccination teams travelling to camps to administer the jab.
But Enas Amer, 27, one of the vaccination crew, told The Telegraph that the health workers “also suffer from lack of transportation”, as the bomb-ridden streets mean they could only travel by foot.
Families also have a short window, between 8am to 2pm, to reach the vaccination clinics during “humanitarian pauses” on the allotted days.
Rana Al-Wahidi, 29, was only able to vaccinate her two daughters, aged six and five, when a mobile vaccination team reached the displacement camp in Deir al-Balah where she was sheltering.
“I do not have money to pay the fare [to reach the vaccination centres, and I am also afraid of the continuous and non-stop bombing,” she told The Telegraph. “I am not the only one waiting for the vaccination team to arrive. Dozens of women are in a different and tragic situation.”
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