4 min readNew DelhiNov 18, 2023 07:55 AM IST
First published on: Nov 18, 2023 at 02:25 AM IST
An estimated 11 lakh children in India missed their crucial first dose of measles vaccine in 2022, according to a report by the World Health Organization and US Centres for Disease Control and Prevention (CDC). This puts India among 10 countries with the highest number of children who did not receive the first shot.
India is also among the 37 countries that witnessed large or disruptive outbreaks, reporting 40,967 measles cases in 2022, according to the report.
Globally, immunisation against measles dropped to lowest levels since 2008 during the pandemic, leading to an 18% rise in cases and 43% increase in deaths in 2022, said the report that presented the first estimates of gaps after the pandemic.
“There was a dip in routine immunisation during 2020 and 2021 because of the pandemic. The challenge with measles is even if a single cohort misses out on vaccination, they become extremely vulnerable to the infection. The gaps in immunisation during the pandemic were mainly in peri-urban areas and clusters where the outbreaks were later reported,” said Dr N K Arora, head of the National Technical Advisory Group on Immunisation (NTAGI).
Two doses of the measles vaccine offers 97% protection for life. The protection is likely to be weaker with a single dose. While measles usually causes high fever, cough, runny nose, and red rashes, complications such as brain swelling, pneumonia and breathing problems, and severe diarrhoea may lead to death.
According to the report, 33 million children globally missed either both doses or second dose.
ExplainedElimination target
THE REPORT comes at a critical juncture as India, along with other countries in the WHO South-East Asia Region, adopted the goal of measles elimination by 2023. While the government has tried to catch up after the pandemic with Indradhanush to achieve the elimination target, India would need to vaccinate 95% of the children.
Dr Arora said the gaps in immunisation have since been covered during the three rounds of Intensified Mission Indradhanush that ended in October. This mission ensures immunisation services reach children who missed out on shots.
“This year, the coverage of the campaign was expanded to include children up to the age of five years as opposed to two years. This was mainly done to ensure high coverage of the measles-rubella vaccine to reach the goal of elimination,” said Dr Arora.
Speaking about sensitivity of measles surveillance in India — another indicator the report looks at, adding that only half the countries have reached the target — Dr Arora said India has performed extremely well. “Globally, a non-measles discard rate of 2 per 100,000 is considered sensitive enough. India has a sensitivity that is three to four folds better.”
With most of the country’s health machinery busy dealing with Covid-19, there was a decline in coverage. This led to an increase in measles cases reported mainly from five states — Bihar, Gujarat, Haryana, Jharkhand and Maharashtra. At least 13 deaths were reported in Maharashtra in 2022. This led to the government launching an outbreak response immunisation drive, vaccinating 13 lakh children between the ages of nine months and 15 years in the affected states and their neighbours between November 2022 and May 2023. “The outbreak can be considered a blessing in disguise. It ensured that children in the region are naturally immunised and government has given shots to those living around,” said Dr Arora.
While the government has tried to catch up after the pandemic with Indradhanush to achieve the elimination target, India would need to vaccinate 95% of the children. 
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