On March 16th, India celebrates National Immunization Day (NID), highlighting the vital role of full vaccination in protecting children from vaccine-preventable diseases (VPDs). This focus on immunization is particularly timely as India builds on its remarkable public health achievement of polio eradication in 2014. Now, the country is taking proactive steps to eliminate another major public health threat: measles.
The measles virus stands as one of the most highly contagious human viruses worldwide, claiming the lives of over 100,000 children annually on a global scale.Measles, a respiratory illness, also remains a significant threat to children in India, particularly those in vulnerable communities. The disease can lead to complications like pneumonia, encephalitis (brain swelling), and even death. However, recognizing the urgency of addressing this preventable disease, India is drawing valuable lessons from its polio eradication program to tackle this challenge.
Learning from polio eradication
India’s success in eradicating polio offers valuable insights for combating measles. The polio eradication campaign laid a strong foundation by establishing an extensive infrastructure for vaccination campaigns nationwide. This network, comprising health workers, cold chain facilities, and robust monitoring systems, now forms the backbone of efforts to immunize against measles.
Similarly, the emphasis on community engagement and mobilization, a hallmark of the polio campaign, is being replicated for measles. Local leaders and community health workers are actively involved in raising awareness, addressing vaccine hesitancy, and ensuring that every child receives vaccination.
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Additionally, the targeted outreach strategies employed during the polio program, which focused on reaching children in remote or underserved areas, are equally vital for measles control. Special efforts are being made to identify and vaccinate unvaccinated children, emphasizing the importance of equitable access to immunization services in the fight against measles.
Challenges in the fight against measles
Despite the valuable lessons learned, eliminating measles presents its own set of challenges.
• Maintaining High Vaccination Rates: Measles requires a high vaccination coverage rate (around 95%) to achieve mass immunity and prevent outbreaks. Achieving and sustaining this level of coverage across India’s vast and diverse population is a significant hurdle.
• Vaccine Hesitancy: Misinformation and mistrust surrounding vaccines can pose a challenge. Effective communication campaigns are essential to address these concerns and educate communities about the importance and safety of measles vaccination.
• Strengthening Surveillance: Robust surveillance systems are crucial for early detection and containment of measles outbreaks. India is implementing improved disease reporting and outbreak response mechanisms to prevent localized cases from escalating into full-blown epidemics.
Building on the polio legacy
Here are some key strategies being employed:
• Measles-Rubella (MR) Vaccination Campaigns: India has adopted a two-pronged approach, combining measles vaccination with rubella vaccination. This strategy protects not only against measles but also against congenital rubella syndrome (CRS), a devastating condition that can affect newborns if their mothers contract rubella during pregnancy. These MR campaigns aim to achieve high vaccination coverage rates in a short period, creating a protective barrier for children across the nation.
• Mission Indradhanush: Launched in 2014, this national immunization mission aims to improve routine immunization coverage in all parts of India, particularly focusing on low-performing districts. This strengthens the overall fight against measles by ensuring children are immunized not just against measles but also other preventable diseases.
• Technology for Improved Outreach: Digital tools are being used to track vaccination progress, identify unvaccinated children, and send targeted reminders to parents. These technological advancements can significantly improve outreach and program efficiency.
The path forward
While India has made significant progress in its fight against measles, challenges persist. To ensure sustained progress, continued efforts are needed. Firstly, increasing investment in immunization programs is crucial. This includes funding for vaccine procurement, maintaining the cold chain infrastructure for storage, and ensuring there’s adequate manpower to carry out vaccination drives.
Secondly, strengthening community engagement is vital. Building trust with communities and addressing their concerns is essential to achieve high vaccination rates. Finally, promoting research and development in areas like improving vaccine efficacy and developing new delivery mechanisms can further strengthen India’s fight against measles. By addressing these areas, India can move closer to eliminating this preventable disease.
By building on the success of polio eradication and implementing a comprehensive strategies, India is making significant progress towards a measles-free future.
(Author: Dr Rajiv Uttam, Director and HOD, Pediatrics, Pediatric Pulmonology and critical care, Medanta, Gurugram)
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