New Delhi: An estimated 11 lakh children missed the first measles vaccination in India in 2022, putting it among the top 10 countries with the highest number of infants who did not receive the crucial first shot against the highly contagious disease, a new report by the World Health Organization (WHO) and US Centers for Disease Control and Prevention (CDC) has said.
Titled ‘Progress Toward Measles Elimination — Worldwide, 2000–2022’, the report was released Thursday.
The findings come nearly a year after many districts in at least five states of India reported an outbreak of measles, an acute viral respiratory disease that strikes and sometimes kills small children.
The outbreaks had forced the Union health ministry to conduct additional measles and rubella (MR) vaccination drives in 85 districts across 16 states, offering an additional dose of the MR vaccine to all children aged between nine months and five years.
A vaccine-preventable viral disease, measles has typical flu-like symptoms and results in characteristic rashes all over the body. In acute cases, it causes pneumonia and inflammation of the brain in young children, which can prove to be fatal.
Experts say the mortality rate of the disease is usually 1-3 percent but can go up to 3-5 percent during outbreaks.
In a statement released in December last year, the central government had said that a total of 3,075 infections and 13 deaths due to measles had been reported from Maharashtra, while a few other states also reported infections.
Under the central government’s Universal Immunization Programme, the MR vaccine is offered in two doses to infants: the first at nine to 12 months and the second at 16 to 24 months of age. The vaccine, in the form of mumps-measles-rubella (MMR), is also available in the private sector.
According to the WHO-USCDC report, during 2021–2022, reported measles incidence increased 72 per cent worldwide, to 29 from 17 per 1 million population, and the number of countries experiencing large or disruptive outbreaks increased to 37 from 22.
Estimated measles deaths increased 43 per cent during 2021–2022, to 1,36,200 from 95,000.
“Following years of decline in measles vaccination coverage, measles cases in 2022 have increased by 18 per cent, and deaths have increased by 43 per cent globally (compared to 2021),” a statement from the WHO said.
The WHO-USCDC report said that “in 2022, measles vaccination coverage and global surveillance showed some recovery from the COVID-19 pandemic setbacks; however, coverage declined in low-income countries, and globally, years of suboptimal immunisation coverage left millions of children unprotected”.
Global vaccine coverage rate of the first measles dose, at 83 per cent, and the second, at 74 per cent, in 2022 was still well under the 95 per cent coverage with two doses that is necessary to protect communities from outbreaks according to the WHO.
Last year, the central government had said that, going by estimates of the WHO and the United Nations International Children’s Emergency Fund, the coverage of the first dose of the MR vaccine was 89 per cent in India, while it was 82 per cent for the second dose in 2021.
The WHO’s Immunization Agenda 2030 includes measles elimination as a core indicator of impact, highlighting the importance of rigorous measles surveillance systems to identify immunity gaps, and of achieving equitable 95 per cent coverage with two timely childhood doses of measles-containing vaccine.
When contacted, Union health secretary Sudhansh Pant, however, said that, according to the Health Management Information System for financial year 2022-23, the first dose of measles and rubella vaccine coverage in India stood at 99.8 percent, while the coverage of second dose stood at 91.6 percent.
“Only 29,276 children missed the first dose of the vaccine. Besides this, several initiatives were undertaken by the government in coordination with the states to ensure that all children, either unvaccinated or partially vaccinated receive all missed/due doses of the vaccine,” said a note shared by the secretary with ThePrint.
The note said that the age of administration of the vaccine has been increased to 5 years from 2 years in the periodic immunisation intensification activities.
It added that the Intensified Mission Indradhanush (IMI) (immunisation in campaign mode) 3.0 and 4.0 were carried out in 2022 and 2023 to catch with the children who may have missed full doses of the vaccine. Also, IMI 5.0 was carried out this year with a special focus to increase the coverage of the vaccine in children up to five years.
“In all these phases, around 5.17 crore children have been vaccinated with due/missed doses of vaccines,” it said.
Also Read: Vaccination gaps, drop in mask use, no social distancing: Why India is seeing measles outbreaks
India’s plan to eliminate measles & rubella
India had first set 2015 as the target for eliminating measles and rubella, which was pushed to 2020 and has now been set for the end of this year.
Virologist Dr T. Jacob John, who is co-chair of the India expert group on measles and rubella, however, told ThePrint Thursday that only 75 per cent of the country’s districts were in a position to declare the diseases “eliminated”, given the vaccination coverage and case numbers.
“This time, we are not going to push back the target as we have been going ahead with a district-specific plan to eliminate the diseases,” he said.
“The districts which are left behind will have to catch up fast, and district magistrates and district immunisation officers will have a crucial role to play in this,” John added.
There is, however, one more problem, the virologist said.
“As a high number of kids had missed out on measles vaccination during the (Covid) pandemic, some of the cases during the 2022 outbreak were also reported in kids aged five to nine years and nine to 15 years,” he said. “It remains to be seen what impact this will have on districts which are performing well towards the disease elimination target.”
(This is an updated report with Union health secretary Sudhansh Pant’s comments)
(Edited by Nida Fatima Siddiqui)
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