How is Pakistan maintaining routine immunisation despite the COVID-19 pandemic?

Despite disruption to routine immunisation in Gavi-eligible countries due to COVID-19, collaborative efforts between Alliance partners and governments have made it possible to partially resume immunisation sessions in countries such as Pakistan.

Gavi/Pakistan/Asad Zaidi


Among Gavi-eligible countries, those in the Asian region continue to report the highest number of cases, driven by Bangladesh and Indonesia, in addition to India and Pakistan. In Pakistan, COVID-19 cases are concentrated in Sindh province, with 43% of all cases, followed by Punjab province with 33%. The capital Islamabad accounts for 5% of cases and Balochistan, Pakistan’s largest province, has 4% of cases.

On 1 April, lockdown measures were put in place for just over a month. In mid-June the government pivoted to a “smart lockdown” in 30 cities, with an aim to contain the spread of the virus while limiting the economic impact. This smart lockdown employs a containment strategy of testing, tracing and quarantining (TTQ) involving increased testing, rapid contact tracing of confirmed positive cases, and effective quarantining of positive and suspected cases. In May, Pakistan’s Minister for Planning, Development & Special Initiatives, Asad Umar, warned that around 18 million people may lose their jobs due to the initial lockdown measures.

While routine immunisation (RI) partially continued, outreach sessions were suspended. As a result, especially during the lockdown, immunisation uptake dropped by more than half, mostly in slum areas and places dependent on outreach for service delivery. More than an estimated one million children had missed vaccine doses by 1 July 2020. In addition, more than 150 Expanded Programme on Immunization (EPI) polio health workers contracted COVID-19.


This could have a huge impact on the spread of diseases like measles and diphtheria, impacting the health of children across Pakistan for years to come. That’s why efforts towards recovery are underway, with enhanced outreach activities starting at the beginning of June in the most impacted districts.

As part of its recovery efforts, the government is considering additional strategies such as extended service delivery and demand promotion to reduce the disruption to immunisation, while supporting COVID-19 prevention efforts. The country will also proceed with polio supplementary immunisation activities (SIAs) in response to an outbreak of circulating vaccine derived poliovirus (cVDPV).

The government, in collaboration with Gavi and its Alliance partners, continues to work on plans to maintain, restore and strengthen immunisation efforts, with an emphasis on tailored services adapted to the needs of the community within the COVID-19 context.

Read the full 28 July situation report, here.