Malawi Expands Polio Immunization With Second IPV Dose to Safeguard Future

In the heart of Southern Africa, Malawi has taken a bold and proactive step in fortifying its defenses against poliovirus, emerging as a continental example of resilience, health system agility, and community-driven success. After confirming a Wild Poliovirus Type 1 (WPV1) case in 2022—the first in 30 years, the country mounted a rapid and strategic response that culminated in its re-declaration as polio-free in May 2024.

But the fight didn’t end with that milestone. In a show of foresight and commitment to long-term protection, Malawi’s Ministry of Health, guided by the Malawi Immunization Technical Advisory Group (MAITAG) and supported by GAVI, the Vaccine Alliance, introduced the second dose of the Inactivated Polio Vaccine (IPV2) into its national immunization schedule in December 2024.

This historic addition ensures enhanced protection against circulating Vaccine-Derived Poliovirus Type 2 (cVDPV2)—a growing threat across Southern and East Africa due to viral mutations in under-immunized communities.

A Nation Mobilized: From Policy to Grassroots Implementation

The introduction of IPV2 was not merely a technical adjustment in the national vaccine calendar—it became a nationwide public health movement. It touched every level of society and galvanized stakeholders from health policymakers to mothers in remote communities.

Key achievements as of April 2025 include:

• 187,348 eligible children vaccinated with the second dose of IPV

• 17,000 health workers trained across all districts on the updated immunization protocols

• Full national coverage, with IPV2 now available at every health facility and outreach post, even in hard-to-reach areas

• Robust community engagement campaigns, led by traditional leaders, health workers, and civil society organizations

• Upgraded data management systems to accommodate new indicators and track IPV2 coverage

The campaign's success is attributed to a multi-pronged strategy that emphasized training, community trust-building, accessibility, and data-driven monitoring.

Karonga: A Border District Leads by Example

In Karonga District, situated along the border with Tanzania—a region vulnerable to cross-border transmission of cVDPV2—the IPV2 rollout has been particularly effective. Local health authorities reported smooth vaccine delivery, high acceptance, and no significant logistical challenges.

Mr. Kayuni, a veteran area supervisor with over 20 years of experience in immunization, praised the community’s role in the rollout.

“We increased awareness campaigns even before IPV2 arrived. People knew what to expect, and the trust built over the years between caregivers and health workers made a big difference,” he said.

Community Voices: Where Trust Translates to Action

At the Mlongoti outreach post, a modest structure built by the community itself, the spirit of ownership and collaboration is palpable. Mothers gather weekly with their children, participating in health talks and receiving services.

Suzgika Gondwe, a local mother, shared, “When I was told this second dose would reduce the risk of polio, I didn’t hesitate. My child’s health comes first.”

Gift Ngofi, another caregiver, added, “I trust what our community health workers tell us. They’ve guided us through so many campaigns, and our children are stronger for it.”

Temwa Kaula noted the broader benefits: “We’ve seen fewer illnesses in our children. It means fewer hospital visits and more time for us to work and provide for our families.”

These testimonials highlight not just acceptance of the new vaccine, but a growing understanding of immunization’s long-term impact on household well-being and economic stability.

Strengthening Systems: The Backbone of Success

Behind Malawi’s vaccination success lies a strong foundation of health system preparedness:

• Cold chain systems were reviewed and reinforced ahead of IPV2 rollout

• Health surveillance assistants (HSAs) were deployed to ensure every child, especially in remote areas, was reached

• Data integration ensured real-time monitoring and troubleshooting of coverage gaps

• Feedback from communities was looped back into policy dialogues through district health review meetings

Global Partnership and National Ownership

This achievement would not have been possible without strong multilateral cooperation. GAVI’s financial and technical backing was instrumental, but equally important was the ownership displayed by Malawi’s Ministry of Health and the unwavering support from national advisory bodies like MAITAG.

The initiative aligns with global polio eradication strategies, particularly in regions still vulnerable to vaccine-derived strains. The IPV2 rollout strengthens population immunity, complements oral polio vaccine (OPV) strategies, and reduces risks of re-emergence.

What’s Next: Sustaining Immunity and Vigilance

With IPV2 now integrated into routine immunization, Malawi’s focus shifts to maintaining high coverage, reaching zero-dose children, and monitoring for any potential resurgence. Surveillance systems remain active and community engagement remains central.

“This success story is not just about a new vaccine—it’s about resilience, trust, and long-term commitment,” said a Ministry of Health official.

Health experts believe that Malawi’s model can inform similar efforts in countries facing rising cVDPV2 threats, particularly in sub-Saharan Africa.

A Future Free of Polio Within Reach

Malawi’s introduction of the second IPV dose is more than a public health milestone. It is a symbol of national resolve, a testament to community collaboration, and a promise to every child that they will be protected from the life-altering impacts of poliovirus.

By building trust, mobilizing resources, and engaging citizens, Malawi is proving that polio eradication is not only achievable—but sustainable. The country stands firm, not just defending its borders from a virus, but paving the way for a polio-free future for generations to come.