Mumbai: Decline in vaccine coverage, weakened measles surveillance, and continued interruptions and delays in immunization activities due to disruptions in the vaccine supply chain during the COVID-19 pandemic caused a resurgence in incidents of measles infections not just in India, but globally.
The focus on zero Covid having caused a slackening in the routine vaccination schedule for the two years of the pandemic, the resurgence of measles raised enough alarm bells in the administration for them to re-focus attention on vaccinating infants and those vulnerable and spread the message of zero Measles across as wide a cross-section of the population as possible.
A two day workshop organised by the Ministry of Health & Family Welfare (MoHFW) in collaboration with UNICEF on December 16, 17, 2022 was part of the administration’s critical outreach to ensure that the message of vaccination and prevention were the only safeguards to save children from the potentially fatal Measles and Rubella. With India reporting over 3,075 infections and 13 deaths due to measles in Maharashtra, as on December 12, 2022, and the highly infectious nature of the disease among infants globally, the South Asian Women in Media (SAWM), a network of women media professionals across South Asia, formed part of the media outreach, collaborating with and supporting UNICEF and the MoHFW in spreading awareness about the vital importance of vaccinating children and eradicating Measles from India by the end of 2023.
Over 60 journalists and media personnel attended the workshop in Mumbai at which the entire spectrum of the health administration, from medical personnel on the ground to officials formulating policy and compiling data, shared crucial data pertaining to the Measles and Rubella (MR) infections across the country. As per official data, India reported over 3,075 infections and 13 deaths due to measles in Maharashtra (till December 12, 20220), Dr. Bharti Pravi Pawar, the Union Minister of State for Health & Family Welfare, stated in a written reply to a question in the Rajya Sabha on December 20, 2022.
The estimated coverage with the first dose of a measles- and rubella-containing vaccine increased from 68% to 89% in 2021, officials stated. Estimated coverage with the second dose of a measles-containing vaccine increased from 27% to 82% in 2021. Available data indicates that between 2017 and 2021, the incidence of measles and rubella declined 62% and 48% respectively.
India had initially targeted 2015 as the year in which the country would be able to eliminate MR, but that target was missed for a variety of reasons. Another new target, to eliminate MR by 2020, was then set but that deadline was also missed, largely due to disruptions caused by the pandemic. A third target, to eliminate MR by end 2023, was set and the administration has pulled out all stops to ensure that target is achieved.
Officials from the MoHFW said they had strengthened their disease surveillance activities after the Covid lockdown ended and have ramped up immunization with measles-containing vaccines, managed vaccine hesitancy through intensive community awareness, improved case management through timely detection and referral and clinical management of cases in the past year.
Dr. Veena Dhawan, Additional Commissioner (Immunization), MoHFW, the death rate of children due to the disease is unacceptably high and most children under the age of five are at high risk. She said that to prevent a backslide on the routine immunization coverage, it was imperative that the media play the role of a vital partner in the country’s healthcare initiatives.
In context of the of the growing number of measles cases, MoHFW officials said one additional dose of Measles and Rubella containing vaccine (MRCV) should be given to all children between 9 months to 5 years in vulnerable areas. This dose should be addition to the primary vaccination schedule of a first dose at 9-12 months and second dose at 16-24 months.
UNICEF’s medical team said the disease had taken an ugly turn in this outbreak, with affected children developing pneumonia within the first week of the infection, thereby leading to heightened fatalities. They also said earlier measles outbreaks were usually reported in winter, but the 2022 outbreak, well before winter was a cause for concern.
Dr. Ashish Chauhan, health specialist, UNICEF, said measles is a ‘tracer’ of strength of the immunisation system. “When immunization coverage is low, measles is the fastest vaccine preventable disease to return,” said Dr. Chauhan.
Dr S. Shukla, Director Immunization, explained out that the disease is mostly similar to the common cold and affected children may have fever and redness in the eyes. He said Vitamin A plays an important role in saving lives of those afflicted with the measles and Rubella infection. “Giving two doses of Vitamin A (therapeutic dose) in a span of 24 hours can save crucial lives,” he said.
Part of the media outreach at the workshop, arranged by leading media professionals including Pankaj Pachauri, former media advisor to the Prime Minister, and Sanjay Abhigyan and Mohamed Ghazali, included presentations on how to most effectively spread the message that vaccines were vital to prevent measles. A SAWM team won first prize for creating an immediate community awareness event for MR vaccination programmes by reflecting the issues health officials confront to convince people, especially in rural areas, to bring their children to be vaccinated. SAWM members also pointed out that, despite India undergoing a digital revolution, the vaccination card still exists only in paper form and does not have any digital footprint, making tracking difficult.
To counter the ‘Infodemic’, a term coined by the World Health Organization which means too much information, including false or misleading information in digital and physical environments during a disease outbreak, health authorities at the workshop urged media including SAWM members, to join forces to eliminate the dreaded disease, which is very preventable.
SAWM members across the eight countries in South Asia have shared this crucial message by holding special online webinars, sharing online tools to identify and eliminate misinformation from their reports and update each other with latest reports on MR infections and other health issues in their respective nations.
