An infant found unvaccinated during a national immunization day house-to-house campaign in Lobito, Angola.

Child to Child

Polio eradication exemplifies the public health tenet of “health for all.” In 2001, the slogan “Every Child Counts” is more than a catchy phrase - it is an operational reality. In 2001, 550 million children were immunized with oral polio vaccine. While the majority were immunized at fixed-site health posts, many needed to be reached by vaccinators going “child to child,” seeking those missed in previous rounds. Program data indicated that extraordinary efforts were needed to reach children in geographically remote areas as well as:

• Newborns and infants
• Children who belong to ethnic, religious, and other minorities
• Street children and children in work places
• Migrant children, children in transit, and children in nomadic groups
• Children living in urban slums, children of squatter families, and internally displaced children
• Children living in high-rise buildings
• Children of elites and children of people employed by elites

Vaccinators need to see and find these children where they really are. No longer can they walk past them or leave them in the background.

Newborns and Infants
In some cultures, newborns and infants are not taken outside the home for extended periods - a week in some places and up to 40 days in others. During these periods, these children never receive polio vaccine from fixed-post immunization sites. Unless house-to-house vaccinators remember to ask for these children, it is unlikely that their mothers will present them to be immunized. In other cultures, babies are swaddled and carried on the mother’s back to fields or markets. Unless a mother knows in advance that house-to-house vaccinators are coming, she may leave the house with her baby, who then does not receive the vaccine.