Israeli forces have killed at least 35 people across Gaza, according to Palestinian officials, as brief and partial pauses in fighting in central Gaza have allowed medics to conduct a further day of polio vaccinations for children.

Among those killed over the latest 24-hour reporting period were four women in the southern city of Rafah and eight people near a hospital in Gaza City in the north, the Palestinian Civil Emergency Service said on Tuesday.

Later, an Israeli airstrike killed nine Palestinians inside a house near Omar Al-Mokhtar Street in the middle of Gaza City, medics said. Another strike hit near a college in Sheikh Radwan, a northern suburb of the city. Others were killed in air strikes across the territory, medics said.

The Israeli military said it killed eight Palestinian gunmen, including a senior Hamas commander who took part in the October 7 attacks in Israel, at a command centre near the al-Ahli Arab Hospital in Gaza City.

A statement said Ahmed Fozi Nazer Muhammad Wadia had taken command of a “massacre of civilians” in Israel’s Netiv HaAsara community near the Gaza border. There was no immediate response from Hamas.

The armed wings of Hamas and Palestinian Islamic Jihad said they were battling Israeli forces in the Zeitoun neighbourhood of Gaza City and also in Rafah and Khan Younis in the south.

Polio vaccination campaign ‘ahead of targets’

Nevertheless, the World Health Organization (WHO) said it was ahead of its targets for polio vaccinations in Gaza on Tuesday, the third day of a mass campaign, and had inoculated about a quarter of Gaza’s children under 10.

After the first confirmed polio case in the territory in 25 years, a massive vaccination effort began on Sunday. The campaign relies on daily eight-hour pauses in fighting between Israel and Hamas fighters in specific areas of the besieged enclave.

United Nations Secretary-General Antonio Guterres described the suspensions in fighting to allow children to be vaccinated as a “rare ray of hope and humanity in the cascade of horror”, his spokesperson said.

“If the parties can act to protect children from a deadly virus, … surely they can and must act to protect children and all innocents from the horrors of war,” Stephane Dujarric said.

With Gaza lying in ruins and the majority of its 2.3 million residents forced to flee their homes due to Israel’s military assault – often taking refuge in cramped and unsanitary conditions – disease has spread.

Al Jazeera’s Tareq Abu Azzoum, reporting from Deir el-Balah in central Gaza, said medical teams were going around tents of displaced people to find children who need to be vaccinated.

“Many families lined up early in the morning to provide their children with additional protection through two oral drops of the polio vaccine,” he said.

“Meanwhile, areas excluded from the so-called humanitarian pause policy are suffering constant bombardment,” he said.

“Consequently, people in these areas are struggling to bring their children to vaccination centres.”

The campaign aims to fully vaccinate more than 640,000 children in the besieged territory, devastated by almost 11 months of war.

Polio primarily affects children under five and can cause deformities, paralysis and in some cases death.

Rik Peeperkorn, the WHO’s representative for the Palestinian territory, said it is vital for the vaccination campaign to reach at least 90-percent coverage to avoid the spread of the disease both within Gaza’s borders and beyond.

The campaign began in the central part of the densely populated Gaza Strip, where the WHO initially expected to vaccinate 156,500 children under the age of 10.

“Our target for the central zone was an underestimation,” Peeperkorn said, adding that this was probably due to more people being crowded into the area than anticipated.

He said the vaccination drive was expected to shift to southern Gaza on Thursday with the aim of immunising 340,000 children there.

It is to then move to the north of the Strip, where about 150,000 children are to be vaccinated.

“We still have 10 days to go at least” for the initial portion of the campaign, Peeperkorn said, and the rollout of the necessary second dose would begin in four weeks.

While polio vaccinations are best carried out in house-to-house campaigns, Peeperkorn said, those are impossible in Gaza because “there’s very few houses left and people are everywhere.”

‘Extremely concerned’

Peeperkorn also warned that the WHO is “extremely concerned” about Gaza’s wider health situation.

With only 16 of 36 hospitals partially operational, the Strip has seen a “huge increase in infectious diseases”.

“We’ve seen more than a million, mainly children, diagnosed with acute respiratory infections,” Peeperkorn said, adding that more than 600,000 children had suffered from diarrhoea.

Israel launched its assault on Gaza after Hamas led an attack on southern Israel on October 7, killing at least 1,139 people, mostly civilians, according to an Al Jazeera tally based on official Israeli statistics.

Promising to destroy Hamas, Israel launched an assault on Gaza, which has killed at least 40,819 people, mostly women and children, according to Palestinian officials.