No needle, no fear, no pain
With jet injectors, polio vaccinators in Afghanistan build trust
On a cloudy morning in Afghanistan’s Laghman province, Dr. Arsala set out for Alingar, a rugged, mountain-wrapped district he had visited many times before. After 12 years as a provincial polio officer, he knew the rhythm of polio campaigns: the early starts, the long drives, the predictable challenges. But this time felt different. He carried a new tool being introduced for the first time in Afghanistan’s polio program: needle-free injections.
From August to October last year, Afghanistan’s polio eradication program launched a three-phase campaign using the inactivated polio vaccine, normally administered through a traditional syringe with a needle. Used alongside the oral vaccine drops, it can boost immunity. The campaign across the eastern region aimed to protect more than 1.2 million children under the age of 5 from polio. Fifty districts, four provinces, and more than 10,000 dedicated polio workers joined forces — and uniting it all was a groundbreaking innovation never before used in the country’s polio eradication efforts.
Instead of shots, the vaccinators introduced jet injectors, spring-powered devices that deliver a tiny stream of vaccine through the outer layer of skin in a split second. There was no needle, no fear, and no pain. Just a quick press, a soft click, and protection delivered with a smile.
Zahir Islam uses a needle-free jet injector to administer a polio vaccine to a child in eastern Afghanistan. “Parents who had avoided injectable vaccines before now brought their children with confidence,” he says.
Image credit: Omid Farooq
It was modern technology meeting some of Afghanistan’s most remote communities.
“This campaign is unlike any I have ever seen before,” Dr. Arsala said as he held the jet injector in his hand. For him, this was not only about new technology; it was about building trust. “This is the first time such a device is being used in polio campaigns in Afghanistan. Delivering high-quality training is crucial. Vaccinators must feel confident before they go to the field.”
Teaching the technique
In a mosque in Alingar, vaccinators gathered, leaning forward with curiosity as trainers like Dr. Arsala and Dr. Jawaid, the district polio officer, demonstrated each step — loading the vaccine, positioning the injector, and administering the dose.
The device, made by a company in Colorado, delivers an intradermal injection into the thick layer of skin called the dermis. It’s simple to operate and requires minimal training. Administering an intradermal injection with a traditional needle, on the other hand, requires a high degree of training and skill.
This particular model of injector is designed specifically for the Global Polio Eradication Initiative to deliver what’s known as a fractional dose of inactivated polio vaccine, shown to afford virtually the same protection as a full dose when given over multiple rounds, while significantly reducing costs.
By the numbers
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1955
First polio vaccine introduced
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99.9%
Worldwide reduction in polio cases since 1988
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2
Countries where wild polio remains endemic
For many frontline polio workers, the campaign in Afghanistan was their first time using such technology.
“This is the first time they are seeing this device,” Dr. Jawaid said proudly. “We make sure they understand every part of it and feel ready to use it.”
For Mohammad Ibrahim, a vaccinator with five years of experience, the device felt like a doorway to the future. “It is much easier than needle injections,” he said. “I’m excited. I’m confident to go into the field and vaccinate children.”
And in the field, something remarkable happened.
Easing caregivers’ concerns
In previous years, some caregivers hesitated as soon as they saw a needle. But now, the reaction was entirely different. Parents gathered around the vaccination sites, curious, relieved, and eager to learn more. “When they learned the device is needle-free and painless, they were eager to see,” said vaccinator Zahir Islam. “Some parents who had avoided injectable vaccines before now brought their children with confidence.”
Vaccinators in Afghanistan learned to use needle-free jet injectors for the first time. Image credit: Omid Farooq
Mothers smiled as their children barely flinched. Fathers watched with relief and admiration as the process took just seconds. Community and religious leaders even publicly encouraged families to embrace the new method, praising it as safer, faster, and more comfortable.
The campaign didn’t just bring a vaccine — it brought renewed trust.
To deliver the best protection, campaigns can use both the oral polio vaccine, delivered with drops on the tongue, and the inactivated polio vaccine in a syringe. The oral vaccine interrupts person-to-person transmission, while the inactivated vaccine offers strong protection against paralysis.
With the jet injector, the experience became cleaner, quicker, and more acceptable — especially important among groups where fear of needles has created real barriers.
“We’ve done surveys among both parents and the vaccinators,” says Ondrej Mach, leader of the research and product development team at the World Health Organization’s polio eradication program. “The vaccinators prefer it because it’s easy to use and there are no needles, and the parents prefer that as well because the children don’t cry. So, I think it probably is good for acceptance. There’s no blood. I’ve tried it on myself. It’s almost painless.”
A global tool
The speed of training, which takes about an hour, is another advantage, he adds, and the devices can be a good investment in places that mount regular vaccination campaigns like Afghanistan and Pakistan, the only two countries where wild polio remains endemic.
Globally, these devices have already been used to vaccinate millions of children in places such as Somalia, Nigeria, and Pakistan. Now, Afghan children would benefit too. And in the hands of dedicated workers like Dr. Arsala, Dr. Jawaid, and thousands of vaccinators across the country’s eastern region, this small device carried something much larger: the promise of a future free from polio.
The 2025 vaccination campaign protected more than 1.2 million children in eastern Afghanistan. Image credit: Omid Farooq
By the end of the third phase, vaccinators across the eastern region had fully mastered the new technology. With each campaign day, they moved from child to child with growing confidence, proud to be part of a campaign that could bring Afghanistan one step closer to ending polio for good.
The country’s eastern region, once a key area of poliovirus transmission in 2022-23, has since made remarkable progress. Conducting the vaccination campaign further strengthens children’s immunity and reduces the risk of poliovirus transmission in this region.
For Dr. Arsala, watching vaccinators use the jet injectors with ease, seeing communities welcome the technology, and witnessing children protected without fear became one of the most fulfilling moments of his long career.
As the campaign closed, Dr. Danish Ahmed, medical officer for the WHO East region, reflected on what it meant for the country’s future. “This campaign is not only about vaccination,” he said. “It is about giving children a safer, healthier future and bringing us closer to the dream of a polio-free Afghanistan.”
Omid Farooq is a communications officer for the World Health Organization. A version of this story was originally published by the Global Polio Eradication Initiative. Learn more at polioeradication.org.
This story originally appeared in the May 2026 issue of Rotary magazine.