In December, Indonesia's health ministry reported two more cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) cases, raising its total since October 2022 to six, the World Health Organization (WHO) said yesterday.

One of the patients is a 6-year-old girl from Central Java province who had recently traveled to Madura Island in East Java province. Her acute flaccid paralysis symptoms began on November 21. She had received two doses of bivalent oral polio vaccine. Genetic sequencing suggests her infection is related to a virus that was identified in a previous case in West Java province in March 2023.
The other patient is a 1-year-old boy from Madura Island in a district that neighbors the one the girl had visited. His paralysis symptoms began on November 22, and he had received four doses of bivalent oral polio vaccine.
Some areas where recent cases were reported have suboptimal vaccine coverage. The WHO said there are no hard-to-reach areas, but sociocultural barriers on Madura Island contribute to vaccine hesitancy, including fear of adverse effects and of multiple injections, and sometimes religious reasons.
Of the Indonesia's four other cases reported since October 2022, three were in Aceh province, with the other in West Java. Detection of cVDPV2 in at least two different sources at least 2 months apart, both with genetic links, shows evidence of community transmission, the WHO said. The agency added that Indonesian officials are conducting active case finding and are boosting efforts to shore up immunization uptake. And, based on the government's request, the WHO has approved the release of 20 million doses of novel oral polio vaccine type 2, the next-generation vaccine designed to curb outbreaks involving cVDPV2.
Three African countries report more cases
In other polio developments, three African countries reported more polio cases, all involving cVDPV2, according to the latest update from the Global Polio Eradication Initiative. All are included in the country totals for 2023.
Guinea reported 3 cases in two provinces, raising its total for the year to 34. Mozambique reported 1 case, in Manica, which marks the nation's first case of 2023. Nigeria reported two 2 cases in Kano, raising the country's 2023 total to 64.