{"doi":"10.1038/s41541-025-01352-1","title":"Progress and gaps in poliovirus immunity: Evidence from a serological survey of children aged 6-23 months in high-risk districts of Pakistan","abstract":"<jats:title>Abstract</jats:title>\n                  <jats:p>Wild poliovirus remains endemic in Pakistan and Afghanistan despite global progress. We quantified immunity to poliovirus types 1–3 among children aged 6–23 months in 44 high-risk districts (2022–2023) using a cross-sectional serosurvey with probability proportional to size (PPS) cluster sampling. We enrolled 20,680 children (10,112 aged 6–11 months; 10,568 aged 12–23 months). Seroprevalence among 6–11-month-olds was 94.5% (type 1), 44.6% (type 2), and 88.0% (type 3); among 12–23-month-olds, it was 95.9%, 53.8%, and 91.2%, respectively. Type 1 seropositivity was highest across provinces; type 3 exceeded 90% except in Balochistan and KP; type 2 was lowest everywhere. Younger children have lower immunity. In multivariable models, residence in Balochistan predicted reduced seroprotection (AOR 0.178, 95% CI 0.066–0.484); older age (AOR 1.356, 1.161–1.583), full immunization (AOR 2.004, 1.643–2.444); and receiving &lt;4 oral poliovirus vaccine (OPV) doses showed higher odds (AOR 1.25, 1.021–1.529) of seroprotection. Wealth showed a non-linear association. Gaps in types 2–3 warrant stronger routine immunization, expanded inactivated polio vaccine (IPV), and tailored supplementary immunization activities (SIAs).</jats:p>","journal":"npj Vaccines","year":2025,"id":649778,"datarank":0.16479184330021646,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"self_citation_contribution":0.16479184330021646,"citation_network_contribution":0.0,"self_endowment_contribution":0.16479184330021646,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1239440,"name":"Ahmad Khan","orcid":"0000-0001-8791-8866","position":1,"is_corresponding":false},{"id":1451756,"name":"Muhammad Umer","orcid":"0000-0002-6015-9326","position":2,"is_corresponding":false},{"id":1356326,"name":"Muhammad Sajid","orcid":"0000-0003-0020-1235","position":3,"is_corresponding":false},{"id":1694027,"name":"Haider Abbas","orcid":null,"position":4,"is_corresponding":false},{"id":673520,"name":"Muhammad Masroor Alam","orcid":"0000-0002-0005-7635","position":5,"is_corresponding":false},{"id":1694028,"name":"Muhammad Anwar-ul Haq","orcid":null,"position":6,"is_corresponding":false},{"id":1694029,"name":"Altaf Bosan","orcid":null,"position":7,"is_corresponding":false},{"id":1694031,"name":"Rehan Hafiz","orcid":null,"position":8,"is_corresponding":false},{"id":1694034,"name":"Jeffrey Partridge","orcid":null,"position":9,"is_corresponding":false},{"id":227077,"name":"Sajid Soofi","orcid":"0000-0003-4192-8406","position":10,"is_corresponding":false},{"id":158160,"name":"Imtiaz Hussain","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Progress and gaps in poliovirus immunity: Evidence from a serological survey of children aged 6-23 months in high-risk districts of Pakistan","abstract":"<jats:title>Abstract</jats:title>\n                  <jats:p>Wild poliovirus remains endemic in Pakistan and Afghanistan despite global progress. We quantified immunity to poliovirus types 1–3 among children aged 6–23 months in 44 high-risk districts (2022–2023) using a cross-sectional serosurvey with probability proportional to size (PPS) cluster sampling. We enrolled 20,680 children (10,112 aged 6–11 months; 10,568 aged 12–23 months). Seroprevalence among 6–11-month-olds was 94.5% (type 1), 44.6% (type 2), and 88.0% (type 3); among 12–23-month-olds, it was 95.9%, 53.8%, and 91.2%, respectively. Type 1 seropositivity was highest across provinces; type 3 exceeded 90% except in Balochistan and KP; type 2 was lowest everywhere. Younger children have lower immunity. In multivariable models, residence in Balochistan predicted reduced seroprotection (AOR 0.178, 95% CI 0.066–0.484); older age (AOR 1.356, 1.161–1.583), full immunization (AOR 2.004, 1.643–2.444); and receiving &lt;4 oral poliovirus vaccine (OPV) doses showed higher odds (AOR 1.25, 1.021–1.529) of seroprotection. Wealth showed a non-linear association. Gaps in types 2–3 warrant stronger routine immunization, expanded inactivated polio vaccine (IPV), and tailored supplementary immunization activities (SIAs).</jats:p>","is_dataset_classified":null,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"41469400","pmcid":"PMC12852092","openalex_id":"https://openalex.org/W7117572773","authors":[],"funders":[{"funder_name":"Bill and Melinda Gates Foundation","grant_id":"OPP1156736","title":null}],"total_grants":1,"fwci":1.58,"citation_percentile":0.87176066,"influential_citations":0,"citation_trend":[{"year":2026,"count":2}],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://www.nature.com/articles/s41541-025-01352-1_reference.pdf","host_type":"journal"},{"url":"https://www.nature.com/articles/s41541-025-01352-1_reference.pdf","host_type":"publisher"},{"url":"https://www.nature.com/articles/s41541-025-01352-1","host_type":"publisher"},{"url":"https://www.nature.com/articles/s41541-025-01352-1.pdf","host_type":"publisher"},{"url":"https://doi.org/10.1038/s41541-025-01352-1","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/41469400","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/12852092","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12852092/","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC12852092","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC12852092?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":["Viral Infections and Immunology Research","Viral gastroenteritis research and epidemiology","Respiratory viral infections research"],"mesh_terms":[],"keywords":["Seroprevalence","Poliovirus","Poliomyelitis","Serology","Seroconversion","Immunization","Vaccination","Odds","Cluster (spacecraft)"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-10T04:18:50.232098Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}