India pushes new single shot Measles-Rubella vaccine, faces resistance

(This is a wrap of coverage on the Measles-Rubella vaccination drive, based on stories produced by journalists from different publications, all of whom had attended a training workshop jointly organised by the Thomson Reuters Foundation and UNICEF.)

The Indian government has kicked off a special immunisation drive against measles and rubella viruses in a bid to eliminate measles and control congenital rubella syndrome by 2020. A single shot Measles-Rubella (MR) vaccine was launched in February 2017 in a phased campaign that aims to ultimately reach 410 million children in the age group 9 months to 15 years, across the country.

Despite the availability of a two-dose measles vaccine under the Universal Immunisation Programme for many years now, full immunisation has been elusive, causing the disease to remain and spread.  The Rubella vaccine is new to the programme.

The first phase of the campaign will cover Karnataka, Tamil Nadu, Puducherry, Goa and Lakshadweep and the dual MR single shot vaccine will be given to children irrespective of whether they have already received any dose of the vaccines previously. After the mass immunisation campaign, the MR vaccine will replace the two-dose vaccine in the routine immunisation programme.

According to a Health Ministry release, measles is a leading cause of death among children; it has killed an estimated 49,200 children in India. It is highly contagious and spreads through coughing and sneezing. Measles can make a child vulnerable to life threatening complications such as pneumonia, diarrhoea and brain infection.

The release said Rubella is generally a mild infection, but has serious consequences if infection occurs in pregnant women, causing congenital rubella syndrome (CRS), which is a cause of public health concern. CRS is characterized by congenital anomalies in the foetus and newborns affecting the eyes (glaucoma, cataract), ears (hearing loss), brain (microcephaly, mental retardation) and heart defects, causing a huge socio-economic burden on the families in particular and society in general. 

The World Health Organisation says that one-third of all measles-related deaths worldwide occur in India. India also accounts for around one third of all children born worldwide with congenital rubella syndrome (CRS).

Suhail Akhtar Qasmi, reported for the Inquilab, that the government expects this campaign to be more challenging than the polio-eradication drive because it targets children up to the age of 15 years also. The two-dose measles vaccine was given to children in the age group 9 to 24 months.

Kamala Thiyagarajan reported for Scroll.in that parents in Tamil Nadu resisted the state’s efforts to vaccinate their children irrespective of whether they had already received a measles vaccine dose as infants.

Prasad of The Hindu quoted Dr Jacob John - co-chairman of the India Advisory Group for Measles and Rubella as saying that the government’s goal for 2020 is eminently doable, if the transmission can be broken.

A mass immunisation drive, which targets large groups of children in a limited timeframe is crucial because it can plug any gaps and contain the spread, through a concept of “herd immunity’ Scroll.in’s Thiyagarajan reported.

It does not matter if some children have been previously vaccinated; repeated vaccination is not unsafe for them, rather it boosts their immunity further.

Sangeeta Barooah Pisharoty reported for The Wire that the campaign was also hit by rumours spread on social media sites. A WhatsApp rumour alleged that the vaccine was aimed at making Muslim children “impotent” and reducing the country’s Muslim population. The rumour reportedly affected the drive’s target delivery in Tamil Nadu, which has usually had good success rates with public health campaigns.

With the rumour – which apparently originated in the Mallapuram area of Kerala – spreading far and wide, health officials in Karnataka had to start a Facebook campaign before taking the programme to the state. Media reports quoting health officials said the rumour even affected the immunisation drive in distant Haryana.

The government will be working with community leaders to dispel misconceptions like they did during the polio-eradication drive some years ago.

Mohammad Sufiyan Saif reported for Akhbar-e Mashriq that Jamiat ul Ulema in Mewat, Haryana convened an emergency meeting soon after to discuss ways to dispel these rumours. Dozens of schools were locked down as a result of the rumours one of the religious leaders said.

Tamil language newspapers reported that the Erode Pediatrics’ Association cleared misconceptions raised through social media messages. The Health and School Education departments reached out to Parent-Teacher Associations to quell the confusion. The Deputy Director of Health Services, Dr. Balusamy, said the combined vaccine was not new; that it was already being administered to many children through private healthcare centres.

Indeed, private practitioners in India have been giving Measles-Rubella or measles/mumps/rubella (MMR) vaccine to children for many years.