11 lakh children in India missed 1st measles shot in 2022: WHO

According to a report by the World Health Organization and US Centres for Disease Control and Prevention (CDC), an estimated 11 lakh children in India missed their crucial first dose of measles vaccine in 2022.

Global Impact:

1. Immunization Decline: Worldwide, measles immunization dropped to its lowest levels since 2008 during the pandemic, resulting in an 18% surge in cases and a distressing 43% increase in deaths.
2. India's Scenario: India, one of 37 countries experiencing large outbreaks, reported 40,967 measles cases in 2022, reflecting the repercussions of vaccination gaps exacerbated by the pandemic.
   
   

Challenges and Vulnerabilities:

1. Routine Immunization Dip: Drastic declines in routine immunization occurred during 2020 and 2021 due to the pandemic, particularly affecting peri-urban areas and clusters.
2. Vulnerability Dynamics: Missing even a single cohort of vaccination leaves individuals highly susceptible to measles, emphasizing the critical importance of maintaining routine immunization.

Measles Characteristics and Impact:

1. Vaccine Efficacy: Two doses of the measles vaccine provide 97% protection for life, with a single dose offering weaker protection.
2. Clinical Manifestations: Measles typically presents with high fever, cough, runny nose, and red rashes. Severe complications, including brain swelling, pneumonia, breathing difficulties, and severe diarrhoea, can lead to fatalities.

Global Response and Sensitivity in India:

1. Global Challenges: Over 33 million children globally missed either one or both doses of the measles vaccine in 2022.
2. India's Performance: Despite challenges, India demonstrated commendable sensitivity in measles surveillance, outperforming global benchmarks by three to four times.

Regional Outbreaks and Government Response:

1. Affected States: Measles cases surged in five Indian states - Bihar, Gujarat, Haryana, Jharkhand, and Maharashtra.
2. Government Intervention: Maharashtra, reporting 13 deaths in 2022, initiated an outbreak response immunization drive, vaccinating 13 lakh children between nine months and 15 years from affected states and neighbouring regions between November 2022 and May 2023.

The measles outbreaks underscore the fragility of global health systems during crises, emphasizing the need for sustained immunization efforts to prevent the resurgence of vaccine-preventable diseases.

What is Measles?

A highly contagious viral infection caused by the measles virus (MeV). It primarily affects children, but individuals of any age can contract the virus.

1. Transmission: Measles spreads through respiratory droplets and is highly contagious, making it one of the most infectious diseases known.
2. Symptoms:
   • Early Symptoms: High fever, cough, runny nose, and red, watery eyes.
   • Later Symptoms: A characteristic red rash that starts on the face and spreads.
3. Complications:
   • Common: Diarrhea, ear infections.
   • Severe: Pneumonia, encephalitis (brain swelling), and, in rare cases, death.
     
     

Impact of Measles:

1. Health Impact:
   • Severity: While most recover fully, measles can be severe, especially in malnourished children or those with weakened immune systems.
   • Fatalities: Complications can lead to fatalities, particularly in populations with limited access to healthcare.
2. Economic Impact:

The economic burden includes healthcare costs for treatment and complications.

• Productivity Loss-Parents may miss work to care for sick children.

3. Public Health Impact:
   • Measles is highly contagious, leading to outbreaks, especially in communities with low vaccination rates.
   • High vaccination rates create herd immunity, protecting vulnerable populations.

Prevention and Control:

1. Vaccination: The measles vaccine is highly effective and is usually administered in combination with vaccines for mumps and rubella (MMR).
2. Routine Immunization: Routine immunization programs aim to achieve high population immunity and prevent outbreaks.

Elimination target:

THE REPORT comes at a critical juncture as India, along with other countries in the WHO South-East Asia Region, adopted the goal of measles elimination by 2023. While the government has tried to catch up after the pandemic with Indradhanush to achieve the elimination target, India would need to vaccinate 95% of the children.