​Polio 

Polio is a highly contagious and lethal disease that is a major priority for global eradication. Pakistan has made significant progress in eradicating polio, with the number of cases dropping from the hundreds to the single digits. 

Researchers at the Department of Paediatrics & Child Health such as Associate Professor Ali Faisal Saleem, have conducted several randomized control trials for the polio vaccine that have contributed to global polio eradication efforts. These studies not only provide scientific evidence to improve routine expanded immunization programs and supplementary immunization but also offer insights into how to manage global polio outbreaks.

The evidence supporting current routine polio vaccination in Pakistan is the Randomized Control Trial on the immunogenicity of different schedules for PV vaccination. The standard routine PV vaccination now includes bivalent Oral PV along with the first dose of IPV.

• ​​Immunogenicity of Different Routine Poliovirus Vaccination Schedules: A Randomized, Controlled Trial in Karachi, Pakistan.​ Saleem AF, Mach O, Yousafzai MT, Khan A, Weldon WC, Steven Oberste M, Zaidi SS, Alam MM, Quadri F, Sutter RW, Zaidi AKM.J Infect Dis. 2018 Jan 17;217(3):443-450. doi: 10.1093/infdis/jix577. https://pubmed.ncbi.nlm.nih.gov/29126173/

The immunity against polio decreases over time. As Pakistan is a country where polio is still prevalent, it is crucial to maintain high antibody levels for all three types of poliovirus (I, II, and III). To achieve this, a second dose of IPV should be administered between 9-12 months after the first dose. Dr. Ali Faisal Saleem's clinical trials have shown that a second dose of IPV not only maintains the immunity against poliovirus but also boosts the immunity in individuals with low immunity levels.

• Immunogenicity of poliovirus vaccines in chronically malnourished infants: a randomized controlled trial in Pakistan. Saleem AF, Mach O, Quadri F, Khan A, Bhatti Z, Rehman NU, Zaidi S, Weldon WC, Oberste SM, Salama M, Sutter RW, Zaidi AK.Vaccine. 2015 Jun 4;33(24):2757-63. doi: 10.1016/j.vaccine.2015.04.055. Epub 2015 Apr 24. https://pubmed.ncbi.nlm.nih.gov/25917673/
  

• ​Immunogenicity of Different Routine Poliovirus Vaccination Schedules: A Randomized, Controlled Trial in Karachi, Pakistan. Saleem AF, Mach O, Yousafzai MT, Khan A, Weldon WC, Steven Oberste M, Zaidi SS, Alam MM, Quadri F, Sutter RW, Zaidi AKM.J Infect Dis. 2018 Jan 17;217(3):443-450. doi: 10.1093/infdis/jix577. https://pubmed.ncbi.nlm.nih.gov/29126173/

Pockets of conflicts persist in Pakistan, rendering some areas hard-to-reach. Other challenges are limited access and an immigrant population, Oral PV vaccine refusals, and a lot of essential immunization zero-dose children. Children are also scared of needle injections. Dr. Ali Faisal Saleem's studies on fractional doses of IPV provide an excellent opportunity in which a needle-free injection for supplementary immunization helps the national polio program reach out to millions of children across Pakistan. Dr. Ali Faisal Saleem is also a master trainer of needle-free devices and has trained the national and provincial polio vaccinators to vaccinate through this device.

• Needle adapters for intradermal administration of fractional dose of inactivated poliovirus vaccine: Evaluation of immunogenicity and programmatic feasibility in Pakistan. Saleem AF, Mach O, Yousafzai MT, Khan A, Weldon WC, Oberste MS, Sutter RW, Zaidi AKM. Vaccine. 2017 May 31;35(24):3209-3214. doi: 10.1016/j.vaccine.2017.04.075. Epub 2017 May 4. https://pubmed.ncbi.nlm.nih.gov/28479178/
• Feasibility of conducting intradermal vaccination campaign with inactivated poliovirus vaccine using Tropis intradermal needle free injection system, Karachi, Pakistan. Yousafzai MT, Saleem AF, Mach O, Baig A, Sutter RW, Zaidi AKM. Heliyon. 2017 Sep 18;3(8):e00395. doi: 10.1016/j.heliyon.2017.e00395. eCollection 2017 Aug. https://pubmed.ncbi.nlm.nih.gov/29333501/