1) Killa-Abdullah district in Pakistan had the highest number of polio cases in 2011 and many vaccine refusals due to religious reasons. 2) To address this, engagement was done with tribal elders, religious leaders, and political parties to gain their support for polio vaccination. Meetings and gatherings brought these groups together. 3) Religious congregations and meetings in mosques and madrassas educated about vaccine safety. Political parties helped provide team members and address refusals. Cross-border coordination also occurred.