Measles Rubella Vaccination

  • Category
    Public Health
  • Published
    24th Jan, 2019

Context

  • The New Delhi High Court stopped the implementation of the ‘Measles and Rubella Vaccine Immunization Campaign’ by the Delhi government. 
  • Around 70 schools in Mumbai city continue to refuse the measles vaccination.

About

Court’s order said that ‘measles vaccination cannot be administered “forcibly” and without the consent of parents,’ it introduced a dimension to vaccination — the question of consent — that had not been adequately dealt with earlier.

Different views on consent

Parents: It is settled principle that choice of an individual, even in cases of life-saving medical treatment, is an inextricable part of dignity which ought to be protected.

Government: Consent in routine immunisation is implied because it is the parents or members of the family who bring the child to the hospital or healthcare centre. For public good and for a vaccine that is tried and tested, there is ample evidence on safety and efficacy and something which is already a part of the universal immunisation programme, written consent should not be essential.

Schools were consciously chosen, rather than health centres or hospitals, because nowhere else can such large numbers of children in the relevant age group be targeted.

Global practice: Parental consent should be obtained prior to vaccination. This is the standard practice around the world. Although, World Health Organization recognises oral, written, and implied consent for vaccination, but countries are encouraged to adopt procedures that ensure that parents have been informed and agreed to the vaccination.

What is MR vaccine?

  • Measles-Rubella (MR) Vaccine was introduced in Universal Immunization Programme in 2017, as Measles-Rubella combination vaccine to provide protection against congenital birth defects caused by Rubella infection for children aged between 9 months and 15 year
  • It is a part of global efforts to reduce illness and deaths due to measles and rubella/ Congenital Rubella Syndrome (CRS) in the country.
  • Measles is a serious and highly contagious disease that can cause debilitating or fatal complications, including encephalitis, severe diarrhoea and dehydration, pneumonia, ear infections and permanent vision loss. The disease is preventable through two doses of vaccine.
  • CRS is an important cause of severe birth defects. A woman infected with the rubella virus early in pregnancy has a 90% chance of passing the virus to her foetus. This can cause the death of the foetus, or CRS.
  • MR vaccine is safe and effective, in use for over 40 years across 150 countries. The vaccine being given in the MR campaign is produced in India and is WHO prequalified.
  • The same vaccine is being given in the routine immunisation programme of India and in neighbouring countries like Bangladesh, Sri Lanka, Nepal and Myanmar.
  • Private practitioners in India have been giving measles-rubella (MR) or measles-mumps-rubella (MMR) vaccine to children for many years.

    Spread of Measles and Rubella in India

    • According to latest Global Measles and Rubella Update, India had 56,399 confirmed measles cases and 1,066 confirmed rubella cases in 2018.
    • As per WHO, measles is a leading cause of death in children, with one-third (around 56,000 in 2011) of all measles deaths worldwide happening in India.
    • Rubella causes birth defects, such as irreversible deafness and blindness in nearly 40 thousand children in India every year.
    • At least 220 million children from 30 states and union territories have already been vaccinated under the nationwide campaign that started in 2017.
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