What to know about polio vaccination campaign in Gaza after 1st first case in 25 years
Majdi Fathi/NurPhoto via Getty Images
(LONDON) — A mass polio vaccination campaign is underway in Gaza to inoculate children after the first case in 25 years was recently detected in the strip.
Several organizations — including the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF), the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), the Hamas-run Gaza Ministry of Health and other partners — began the campaign on Sunday in central Gaza, where the case was confirmed.
The WHO has sent more than 1 million vaccine doses with the goal of vaccinating more than 640,000 children under age 10. The campaign will be rolled out in three-day phases each in central, southern and northern Gaza, according to Dr. Richard Peeperkorn, WHO representative for the Palestinian territory,
The UN estimates that in 2022, polio vaccination coverage, conducted through routine immunization, was at 99%.
However, since the outbreak of the war, this percentage has fallen. According to the latest WHO-UNICEF routine immunization (WUENIC) report, the number is estimated to be at 89% in 2023 due to the number of newborns not vaccinated.
Israel has agreed to limited pauses in the fighting, for about six hours a day, to facilitate the campaign, according to the WHO.
Children will receive two drops of novel oral polio vaccine type 2 (nOPV2), which has been used for outbreak response under the WHO’s Emergency Use Listing approval since March 2021.
“We are targeting 157,000 children under 10 [in central Gaza]. We will do it for three consecutive days and, if needed, we’ll add a day,” Peeperkorn said on Sunday.
The vaccination will target 138 different sites including hospitals, medical points, schools and community points — including water and food distribution points — according to the WHO.
Among those participating in the vaccination campaign is the medical nonprofit MedGlobal. Five of the organization’s medical treatment points in Gaza are ready to administer vaccines.
Dr. John Kahler, a pediatrician and co-founder of MedGlobal, who has been on multiple medical missions to Gaza, said temporary pauses are not enough to fix long-term systemic issues, but this proves they can happen for critical medical situations.
“First of all, it shows how collapsed the public health system is,” he told ABC News. “But it also shows that it is possible for both sides to come to some type of a temporary — but important — agreement to permit [vaccinations] to happen.”
UNICEF said during the first full day of the vaccination campaign, 72,600 children received a dose of polio vaccine.
Poliovirus was first detected in sewage samples from Deir al-Balah and Khan Younis — in central and southern Gaza, respectively — in mid-July, in tests conducted by the Ministry of Health in coordination with the United Nations.
“The presence of the virus that causes polio … represents a new health disaster,” the ministry said in a statement at the time. “There is severe overcrowding, a scarcity of available water and its contamination with sewage water, the accumulation of tons of garbage and the occupation’s prevention of the entry of hygiene materials, which creates a suitable environment for the spread of various epidemics.”
In mid-August, the Ministry of Health reported the first case of polio in 25 years in a 10-month-old child who had not been vaccinated. Doctors suspected polio after symptoms resembled the virus, which was confirmed in test conducted in Amman, the capital of Jordan.
Kahler said the true number of polio cases is likely much higher with many that have got undetected.
“If you really do have one case of paralytic polio, you have, by definition, hundreds or more,” he said. “Remember, 90% of polio is asymptomatic. So, this is why it spreads. It’s highly contagious…Given the breakdown in the infrastructure, there will be no way of knowing how many.”
Polio largely affects children under age 5 and can lead to paralysis or death. According to the Palestinian Central Bureau of Statistics, there are about 341,000 children under the age of five in Gaza.
(BATTLE CREEK, Mich.) Hundreds of people gathered outside the WK Kellogg headquarters in Michigan on Tuesday calling for the company to hold up its promise to remove artificial dyes from its breakfast cereals sold in the U.S.
Nearly 10 years ago, Kellogg’s, the maker of Froot Loops and Apple Jacks, committed to removing such additives from its products by 2018.
While Kellogg’s has done so in other countries including Canada, which now makes Froot Loops with natural fruit juice concentrates, the cereals sold in the U.S. still contain both food dyes and a chemical preservative.
Food activist Vani Hari, also known as the Food Babe on social media, spoke to the crowd of demonstrators at the cereal giant’s offices in Battle Creek on Tuesday.
“I’m here for the moms, all the moms, who struggle to feed their children healthy food without added chemicals,” she said.
In response to the protests, Kellogg’s insisted its products are safe for consumption, saying its ingredients meet the federal standards set by the U.S. Food and Drug Administration.
The agency has said that most children experience no adverse effects from color additives, but critics argue the FDA standards were developed without any assessment for possible neurological effects.
The protests come in the wake of a new California law known as the California School Food Safety Act that bans six potentially harmful dyes in foods served in California public schools. The ban includes all of the dyes in Froot Loops, plus Blue Dye No. 2 and Green Dye No. 3.
The bill was passed by state legislators in August and signed by Gov. Gavin Newsom in September.
Studies suggest that consumption of said dyes and colorants banned under the new California School Food Safety Act may be linked to hyperactivity and other neurobehavioral problems in some children, as the California Environmental Protection Agency’s Office of Environmental Health Hazard Assessment outlined in a 2021 report.
While there are still thousands of chemicals allowed for use in our country’s commercial food system, many of those that have been reviewed by the Food and Drug Administration have not been reevaluated for decades. Red 40, for example, was last evaluated for health risks in 1971.
Reports from the American Academy of Pediatrics align with this push to reassess the safety of artificial food coloring.
California previously made history in October 2023, when Newsom signed AB 418 into law, a first-of-its-kind bill that bans four harmful chemicals from candy, cereals, salad dressings and other processed foods in the state starting in 2027.
That law will end the use of brominated vegetable oil, potassium bromate, propylparaben and Red Dye No. 3 in food products sold throughout the state.
While the United States has made considerable progress fighting the HIV/AIDS crisis since its peak in the 1980s, headway has not been equal among racial/ethnic groups.
Overall, HIV rates have declined in the U.S. and the number of new infections over the last five years has dropped among Black Americans and white Americans. However, Hispanic and Latino Americans have not seen the same gains.
Between 2018 and 2022, estimated HIV infections among gay and bisexual men fell 16% for Black Americans and 20% for white Americans, according to data from the Centers for Disease Control and Prevention. Meanwhile, Hispanic Americans saw rates held steady, the CDC said.
There may be several reasons for the lack of decline, including Hispanic Americans facing health care discrimination, experts told ABC News. Some may also face the stigma that prevents patients from accessing services or makes them feel ashamed to do so. There is also a lack of material that is available in their native language or is culturally congruent, experts said.
“Where we are in the HIV epidemic is that we have better tools than ever for both treatment and for prevention, and we have seen a modest slowing in the rate of new infections, but we have seen a relative increase in the rate of new infections among Latino individuals, particularly Latino men who have sex with men,” Dr. Kenneth Mayer, a professor of medicine at Harvard Medical School and medical research director at Fenway Health in Boston, told ABC News.
“So, the trends are subtle, but they’re concerning because it does speak to increased health disparities in that population,” he continued.
Hispanic Americans make up more cases and more deaths
Although Hispanic and Latino Americans make up 18% of the U.S. population, they accounted for 33% of estimated new HIV infections in 2022, according to HIV.gov, a website run by the U.S. Department of Health and Human Services. This is in comparison with white Americans, who make up 61% of the U.S. population but just 23% of HIV infections.
Hispanic and Latino gay men currently represent the highest number of new HIV cases in the U.S.
What’s more, Hispanic males were four times likely to have HIV or AIDS compared to white males in 2022 and Hispanic females were about three times more likely than white females to have HIV over the same period, according to the federal Office of Minority Health (OMH).
Additionally, Hispanics males were nearly twice as likely to die of HIV Infection as white males and Hispanic females to die of HIV Infection in 2022, the OMH said.
Erick Suarez, a nurse practitioner and chief medical officer of Pineapple Healthcare, a primary care and HIV/AIDS specialist located in Orlando, Florida, told ABC News that watching the lack of progress made in the HIV/AIDS crisis for the Hispanic and Latino population is like “traveling back in time.”
“When I say traveling back in time for the Hispanic/Latino population with HIV, I mean [it’s like] they are living before 2000,” he said, “Their understanding of treatment and how to access it is in that pre-2000 world. … The state of HIV and AIDS in the Hispanic/Latino population in the United States right now is a few steps back from the general American population.”
He said many Hispanic/Latino HIV patients come to the United States unaware of their HIV status. If they are aware of their status, they come from countries where prevention and pre-exposure prophylaxis (PrEP) is hard to find or doesn’t exist.
When they get to the United States, they be afraid or unsure of where or how to access health care. Even Hispanic/Latino Americans whose families have been here for generations, have trouble accessing health care due to racial and ethnic disparities, Suarez said.
Previous research has shown Hispanic/Latino Americans with HIV reported experiencing health care discrimination, which could be a barrier to accessing care.
Facing discrimination, stigma
Hispanic and Latino patients with HIV report facing discrimination in health care, experts told ABC News. A CDC report published in 2022 found between 2018 and 2020, nearly 1 in 4 Hispanic patients with HIV said they experienced health care discrimination.
Hispanic men were more likely to face discrimination than Hispanic women and Black or African American Hispanic patients were more likely than white Hispanic patients to face discrimination, according to the report.
There may also be stigma — both within the general population and within their own communities — associated with HIV infection that could prevent patients from accessing services, according to the experts.
Suarez said one of his most recent patients, who is Cuban, traveled two hours to a clinic outside of their city to make sure no one in their familial and social circles would know their status.
“The interesting part is that even though I speak with them like, ‘You understand that everything that happens within these walls is federally protected, that it is private information. No one will ever know your information, and our goal is for you to get access healthcare. You can do this in your own city,'” Suarez said.
“Now, because of the stigma, they will travel long distances to avoid contact with anyone and make sure that no one knows their status. So, stigma is a huge factor,” he continued.
Rodriguez said this stigma and mistrust has led to many Hispanic and Latino Americans to not seek medical care unless something is seriously wrong, which may result in missed HIV diagnoses or a missed opportunity to receive post-exposure prophylaxis, which can reduce the risk of HIV when taken within 72 hours after a possible HIV exposure.
Making resources ‘available, attainable and achievable’ Experts said one way to lower rates is to make information on how to reduce risk as well as how to get tested and treated available in other languages, such as Spanish, and making sure it is culturally congruent.
However, Rodriguez says translating documents is not enough. In the early 2010s, when the CDC was disseminating its national strategy to reduce HIV infection, the agency began to circulate materials on how to reduce HIV incidence, reducing stigma and increasing use of condoms for sex, Rodriguez said.
He said that of a compendium of 30 interventions, maybe one was in Spanish. When he took the materials back to his native Puerto Rico, many were having trouble understanding the materials because it has been translated by someone who is of Mexican heritage.
Secondly, rather than the materials being written in Spanish, they had been translated from English to Spanish, which doesn’t always translate well, Rodriguez said.
“When we talk about Hispanics, we have to talk about, first of all, the culture. Our culture is very complex. Not one Spanish language can speak to all of the Hispanic communities,” he said. “And then we also have to look at the generations of Hispanics. Are you first generation, second generation, third generation? “
He added that the key is making resources “available, attainable and achievable.”
This month, the White House convened a summit to discuss raising awareness of HIV among Hispanic and Latino Americans and to discuss strengthening efforts to address HIV in Hispanic and Latino communities.
Mayer said it’s also important to make sure information is disseminated on social media that is culturally tailored for Hispanic and Latino experiences.
“It’s important for social media to seem culturally relevant, to make sure that they understand that HIV is not just a disease of old white guys, and that they may have a substantial risk,” he said. “Make sure that they’re educated by what they can do to protect themselves since we have highly effective pre-exposure prophylaxis, and we have ways to decrease STIs with a doxycycline post-exposure prophylaxis.
The experts added that having more Hispanics and Latinos represented in medicine, research and public health may encourage more Hispanic and Latino Americans with HIV or at risk of HIV to seek care or treatment.
“Seeing and being able to recognize that your healthcare provider looks like you, sounds like you, in some way it represents you, is a key aspect of getting people on treatment and access,’ Suarez said. “And not only that, but keeping them in treatment and having them come back and stay and keep that going, that’s a key issue.”
The election of former President Donald Trump to a second term has put a spotlight on what his return to the White House may look like, particularly when it comes to women’s health.
Online searches for topics related to women’s health have spiked since the Nov. 5 election, particularly when it comes to birth control, Google data shows.
Searches for IUDs, birth control pills, and Plan B are trending higher than they have since June 2022, when Roe v. Wade was overturned, giving states the power to decide abortion access.
Since then, at least 14 states have ceased nearly all abortion services, and 21 states have put into effect restrictions on abortion.
The current abortion landscape combined with Trump’s comments about birth control on the campaign trail and his first administration’s efforts to roll back insurance coverage of contraceptives have led to uncertainty about what will happen in his second term.
Here are five questions answered.
1. What does the term ‘birth control’ include?
Birth control, also known as contraception, is the broad term for the act of preventing pregnancy.
The term includes everything from medicines and methods to devices and surgery used to prevent pregnancy, according to the National Library of Medicine.
One of the most widely-known and used types of contraception is the birth control pill, an oral, hormonal medication that commonly requires a prescription.
Around 14% of women in the United States between the ages of 15 to 49 currently use the pill, according to the Centers for Disease Control and Prevention.
2. What did Trump say about birth control on the campaign trail?
During an interview with a Pittsburgh TV station in May, Trump was asked if he supports any restrictions on a person’s right to contraceptives.
“Well, we’re looking at that and we’re going to have a policy on that very shortly,” Trump responded with. “And I think it’s something you’ll find interesting and it’s another issue that’s very interesting.”
When asked to clarify if he was suggesting he was open to supporting some restrictions on contraceptives, “like the morning-after pill,” Trump responded, “Things really do have a lot to do with the states — and some states are going to have different policy than others.”
The former president quickly took to social media to clarify his position, claiming that he was not advocating for restrictions on contraceptives.
“I HAVE NEVER, AND WILL NEVER ADVOCATE IMPOSING RESTRICTIONS ON BIRTH CONTROL, or other contraceptives,” he wrote in a May 21 post on his social media platform.
The Trump campaign further attempted to clarify, claiming the policy Trump was referring to during the interview was mifepristone, often used in pregnancy termination. However, Trump was not asked about the abortion medication.
After winning the 2024 presidential election, Trump and the transition team have been advised on health-related appointments by Robert F. Kennedy Jr., who has also been in discussions to possibly fill a major role in the next administration, sources familiar with the matter told ABC News.
ABC News has not found public comment from RFK Jr. on the issue of birth control.
3. What happened on birth control during Trump’s first administration?
During Trump’s first term, the Department of Health and Human Services issued new rules allowing more employers to opt-out of the Affordable Care Act mandate guaranteeing no-cost contraceptive services for women.
The Supreme Court upheld the HHS decision in a 7-2 ruling in 2020, giving an employer or university with a religious or moral objection to opt out of covering contraceptives for employees.
4. As president, what power does Trump have over birth control?
As president, Trump would have the authority to order rollbacks of measures implemented by President Joe Biden’s administration to protect birth control.
As recently as October, the Biden administration announced a plan to require insurers to fully cover over-the-counter contraceptives.
In January, the administration announced several other measures to protect contraception access, including federal agencies issuing new guidance to “clarify standards” and make sure Food and Drug Administration-approved contraceptive medications are available for free under the Affordable Care Act.
Once Trump is in office, he will also have the chance to appoint Supreme Court justices if vacancies arise. During his first term, Trump appointed three justices.
Trump could also work with Congress to enact legislation on women’s reproductive rights, including birth control. Following the Nov. 5 election, control of the House of Representatives is still up in the air, while ABC News has projected that Republicans will win the Senate.
5. What has the Supreme Court said on birth control?
When the Supreme Court overturned Roe v. Wade in 2022, a solo concurring opinion by Justice Clarence Thomas included a line on birth control.
In his opinion, Justice Clarence Thomas wrote that the court “should reconsider” Griswold v. Connecticut, the Supreme Court ruling that invalidated a Connecticut law that made it illegal to use birth control devices or to advise about their use.
“We have a duty to ‘correct the error’ established in those precedents,” Thomas wrote, citing the Griswold ruling among others.
ABC News’ Lalee Ibssa, Will McDuffie, Kelsey Walsh and Soo Rin Kim contributed to this report.
