As India remains busy with COVID vaccines, the measles programme receives little attention
One hopes the hurry to administer COVID-19 vaccination doses to the adult population has not adversely impacted the routine infant immunisation programmes in the country, especially the measles vaccination campaign. The WHO says more than 22 million infants globally, including India, may have missed the first dose of the measles vaccine – Measles-Containing Vaccine 1 (MCV1). The WHO findings were published in the Morbidity and Mortality Weekly Report of the Centers for Disease Control and Prevention. It says 24 measles vaccination campaigns in 23 countries were postponed last year because of the COVID-19 lockdown. The “10 countries with the highest numbers of infants not receiving MCV1 were Nigeria (3.3 million), India (2.6 million), the Democratic Republic of the Congo (1.5 million), Ethiopia (1.4 million), Indonesia (1.1 million), Pakistan (1.0 million), Angola (0.7 million), the Philippines (0.6 million), Brazil (0.6 million) and Afghanistan (0.4 million); accounting for nearly two thirds (59 per cent) of the global total”. There was a global resurgence in measles incidence between 2017-2019 but that was followed by a decline in 2020 when the pandemic lockdown was in place. With the entire medical infrastructure geared towards tackling the COVID-19 infection, attention was diverted from other essential medical campaigns, including the immunisation campaigns. The WHO calculates apart from the 22-odd million infants, at least “93 million persons did not receive MCV because of COVID-19-related postponements”. With the lockdown in place, most centres were closed down, there was a problem carrying out the campaign at the village level. Subsequently, the country was busy with the anti-virus vaccination and the measles programme perhaps got little attention.
It is time the Government and the NGOs running the measles and other infant immunisation campaigns ramp up their efforts to give MCV1 doses to children. Measles surveillance has to be taken up once again so that the measles surveillance sensitivity indicators are readily available. Considering the gap in measles immunisation, a national survey is called for to assess any immediate risk for measles transmission and outbreaks in the country. The survey needs to be followed up by case-based surveillance to document immunity gaps. If there are any outbreaks, they should be the opportunity to look for weaknesses in the renewed immunisation campaigns. Most of the infants who missed the first measles dose may have turned two by now; whether they also need to be vaccinated against COVID-19 is another issue. If there is a debate in the medical profession about whether all children need COVID-19 vaccination, it has not yet become part of public discourse. Any vaccination as such is mandatory and problems such as hesitancy, complacency or campaign delays should be resolved at the earliest.