Measles immunization India still needs an aggressive campaign

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Today is measles immunization day. India, along with ten other WHO South East Asia Region member countries, has resolved to eliminate measles and control rubella/congenital rubella syndrome (CRS) by 2020. In this direction, Ministry of Health & Family Welfare has initiated measles-rubella (MR) vaccination campaign in the age group of 9 months to less than 15 years in a phased manner across the nation. The campaign started on Feb 2017, aims to cover approximately 410 million children.

 

After carrying out two phase of a successful measles rubella immunization program in last two years, the recent phase is a major setback to the ambitious project. The third phase started from January 2019, has to cover 220 million children of 9 to 15 years of age from 30 states across the country, for measles and rubella vaccination. But the ride goes bumpy in capital Delhi itself where all process has to be halted after the high court direction.  High court order came on a petition filed by 6 parents of Modern school challenging government’s blanket order to vaccinate each and every children. High court ordered that govt. can’t force anybody to get vaccinated. HC told health department to advertise and sensitize public about MR Veccine through newspapers, take consent from parents and schools and maintain the record that who all r not get vaccinated.  But department is finding it impractical.  Talking to health wire, special project officer, immunization, health and family welfare department of Delhi Dr Suresh Seth said “we are planning to appeal against HC order in higher bench.  What HC has ordered is not practical.  If we go in so much of record keeping, target of vaccination for 95 percent of population in short span can never be achieved” Delhi department also followed the center govt. direction which has been followed in all other states but no- body has problem. Here in Delhi only we could not even started the program he added.

Similar problem has been faced in Maharashtra also, where in Mumbai itself 70 schools refused to take part in the Govt. MR program and the civic body could vaccinate only 19.5 lac children of its nearly 29 lac target.

“We are not forcing but we have to make people understand that unless over 95% coverage is achieved, the target to eliminate measles and rubella in India cannot be achieved.” Said a higher official in health department.

According to WHO data 1.3 million Indian children contact measles every year. This also makes them prone to pneumonia and diarrhea severe enough to need hospitalization, encephalitis which can lead to mental disability, complications with hearing and sight; 49,000 die every year, 36% of the world’s burden. A different virus causes rubella, with the same red rash. It’s less virulent, but in expectant mothers it could result in fetal death or abnormalities; it accounts for 40,000 birth defects annually in India. Due to measles being highly infectious, the WHO stated that a country needs to ensure that at least 95% of all children receive two doses of the vaccine.

About 15% of vaccinated children fail to develop immunity from the first dose, meaning that if only 80% are fully immunized, an outbreak is likely. According to the World Health Organisation (WHO),  vaccine hesitancy or the reluctance or refusal to vaccinate against communicable diseases, despite the availability of vaccines is one among the ten biggest global health threats of 2019 is. Vaccine hesitancy, according to WHO, could reverse the progress made in tackling vaccine-preventable diseases over the last decades.

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