A newborn in Mozambique received his first dose of a life-saving vaccine thanks to a door-to-door polio campaign—and even got a name from the healthcare workers who delivered it. It was afternoon in a remote village in Inhambane province when a team of three discovered the one-week-old boy hadn’t been officially named during a routine visit on June 26, 2025.
Millions of children in Mozambique are benefiting from national polio campaigns, with healthcare workers going to extraordinary lengths to reach every child, even those previously untouched by vaccination efforts.
- Mozambique declared a wild poliovirus outbreak in 2022, ending a 30-year period of being polio-free.
- Under-immunization rates rose dramatically in recent years, reaching 750,000 children by late 2023—a significant increase from 97,000 four years prior.
- Healthcare workers are actively seeking out “zero-dose” children—those who have never received any vaccinations—to protect them from outbreaks.
- Integrated vaccination campaigns are now delivering multiple vaccines during a single visit, increasing efficiency and access.
Little Evanildo, as he came to be called, was one of millions vaccinated during the 2025 campaigns. Healthcare workers traveled by car, motorbike, bicycle, boat, and, most often, on foot to reach every child. For many, it was a booster; for others, it was their very first vaccine.
“For routine immunization, there is a big drive of wanting vaccines, but you have to look at how it works,” explained Jan-Marcus Hellström, UNICEF polio team lead in Mozambique. “If you have to walk for many hours to get to a health center instead of working to put food in front of your children, you might think twice. It isn’t vaccine hesitancy per se – you just have to make it convenient. And what’s convenient with polio [vaccinations] is that we go out to the children.”
Mozambique’s Fight Against Polio and Rising Under-Immunization
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Maria Mario, one of over 70,000 vaccination workers, embodies this commitment. Based near Tofo, she focuses on routine health services—from immunization to sanitation—and diligently tracks down unvaccinated children. “I’m the one who vaccinates the children here, who knows which child hasn’t been vaccinated,” she said. “It’s not just vaccinating against polio, but I do it routinely. When a mother comes here with a child who is unvaccinated or not following the schedule, I get upset and then I hug the child.”
A: The country declared a wild poliovirus outbreak in 2022 after the virus was imported, ending 30 years without a case. This, coupled with rising under-immunization rates, created a vulnerable population.
Mozambique declared a wild poliovirus outbreak in 2022—after 30 years free from the disease—following an imported case. The highly infectious virus, spread through contaminated water and food, primarily affects children under 5 and can cause paralysis. Following the closure of the wild poliovirus outbreak in May 2024, vaccination efforts led by the Ministry of Health and the Global Polio Eradication Initiative (GPEI) continued against poliovirus strains.
Recent years have seen a concerning rise in under-immunization, fueled by disruptions from the COVID-19 pandemic, Cyclone Freddy, the polio outbreak, and outbreaks of measles and cholera. The number of unimmunized children climbed to 750,000 by late 2023, up from 97,000 just four years earlier. A nationwide effort was launched to address this decline.
“Zero-dose kids are children that have never received a vaccine in their lives,” said Hellström. “They’ve been left out of the system, for various reasons, and are, of course, more vulnerable to diseases.” These children are a priority, as they are most susceptible to infection and can become “Patient X” in an outbreak.
Reaching Remote Communities and Integrating Health Services
Community health workers like Mario are central to Mozambique’s immunization strategy. “I don’t know how this spirit grew in me, but I feel relieved when I administer vaccines,” she said. “I like to see the children healthy, that’s why I love my field. I do it from the heart, because these immunizations strengthen us.”
During the national polio campaigns in June and July 2025, Mario diligently tracked down children without a painted finger—a marker indicating they’d received the oral nOPV2 poliovirus vaccine—even revisiting schools to ensure every eligible child was vaccinated. “This area is huge, so here it’s all about walking – until you feel pain,” she said, describing days involving 25,000 steps. “It’s difficult, but I try to do everything so that the children are covered. If I have a hundred percent of my area, then I am very happy about that. Considering there aren’t many refusals for me here, it’s wonderful.”
Health technician Maria Mario works with children in Inhambane province, managing routine immunization along with participating in one-off vaccination campaigns.
In remote districts, vaccination teams can walk for four hours to reach just a few children. “People are not static,” Hellström said. “If you’re not at home, or school, or the marketplace, we will find you one way or another, because there are so many teams out there.” These interactions also provide an opportunity to discuss routine immunization schedules and address other health concerns.
The success of Mozambique’s outbreak response, and the ultimate goal of polio eradication, hinges on closing the immunity gap. “We could have a hundred percent high quality campaign to improve community immunity, but at the same time, individual immunity relies solely on routine immunization,” said Nirakar Panda, then-coordinator for polio outbreak response in Mozambique.
Expanding the Scope: Integrated Campaigns
Outbreak responses are increasingly tailored to address regional health needs. Madagascar, while free of wild poliovirus, has experienced outbreaks of type 1 variant polio, with 55 children paralyzed between 2020 and 2023. Vaccination campaigns have increased healthcare access in hard-to-reach areas.
The GPEI’s strategy emphasizes co-delivery of vaccinations and coordination with organizations like GAVI, the vaccine alliance, to strengthen routine immunization. For example, in 2024, a joint polio and measles campaign targeted zero-dose children and those missing routine vaccinations. Polio teams also distributed vaccinations for lymphatic filariasis in 2023 and 2024. In South Sudan, schistosomiasis treatment has been rolled out alongside polio vaccination, while Nigeria has distributed measles and rubella vaccines.
Healthcare worker Maria Mario manages community health in and around her health center and combs the area for any children missing their vaccines, including visiting local schools.
For Mario, vaccines are simply life-savers. “We know that the polio vaccine prevents infantile paralysis, so this vaccine protects our children – it’s that simple,” she said. While outbreaks demand targeted responses, routine immunization remains essential.
“In order to eradicate polio, we need to ensure that routine immunization is picked up all over the world,” said Hellström. “An unvaccinated child, anywhere, is a threat to children everywhere.”
Editor’s Note: This reporting was made possible through the United Nations Foundation 2025 Press Fellowship on Individual Reporting on Polio.