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LETTER TO THE EDITOR
Year : 2016  |  Volume : 2  |  Issue : 2  |  Page : 109-110

Enormous need to improve the global measles vaccination coverage: World health organization


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Kancheepuram, Tamil Nadu, India

Date of Web Publication19-May-2016

Correspondence Address:
Saurabh RamBihariLal Shrivastava
Department of Community Medicine, 3rd Floor, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur - Guduvancherry Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2394-7438.182724

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How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Enormous need to improve the global measles vaccination coverage: World health organization. MAMC J Med Sci 2016;2:109-10

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Enormous need to improve the global measles vaccination coverage: World health organization. MAMC J Med Sci [serial online] 2016 [cited 2019 Nov 12];2:109-10. Available from: http://www.mamcjms.in/text.asp?2016/2/2/109/182724

Sir,

Measles is an extremely infectious disease caused by a virus which is known to infect only humans.[1] However, despite the existence of an effective vaccine for more than three decades, measles continues to be one of the most common causes of mortality among children in the under - 5 years age group.[1] In fact, as per the recent global estimates available, measles accounted for close to 400 deaths each day in the year 2013, which is an alarming public health concern.[2]

Further, there is no doubt about the effectiveness of the vaccine as it has brought about a 79% reduction in the number of measles deaths in the period of 2000 (0.55 million) to 2014 (0.12 million).[2],[3] In addition, immunization with measles vaccine has played a crucial role in reducing the child mortality (viz., in excess of 17 million lives saved since the beginning of the 20th century) and in moving closer toward the Millennium Development Goal 4.[2],[3]

However, the current global concern is not about the gains achieved, but about the stagnation in immunization coverage, which has been observed in the last 4 years.[2] This is primarily due to no betterment in the global immunization coverage (with the first dose of measles vaccine) during 2010–2014 despite recording a significant improvement of 13% in the first decade of the 20th century.[2] Further, only 63% of the member states of the World Health Organization (WHO) have met the target of immunizing at least 90% of children with measles first dose while <50% of the world's children have been immunized with the globally recommended second dose of the vaccine.[2] All those nations which have succeeded in improving the administration of the second dose of the measles vaccine, it has been predominantly attributed to the sustained funding by the international agencies, strengthening of the surveillance system and laboratory network, and better microplanning to administer second dose (viz., vaccine management issues, advocacy communication and social mobilization activities, sensitization of the health workers, improving the demands for the vaccine, strengthening of the monitoring, and evaluation component of the immunization, etc.).[1],[3],[4],[5] Further, close to 18.7 million infants are still missing out with the basic vaccines across the world, and it has been anticipated that the global target to bridge the immunization gap will not be achieved, and millions of children will continue to die of those diseases which are completely preventable.[3],[4],[6]

It is also important to understand that measles coverage might remain less in comparison to other vaccines as it requires additional efforts and thus even if other vaccines are taken, measles may be still missed, especially the second dose of the vaccine.[4],[6] Even though the international stakeholders and country's policy makers are trying to improve the measles vaccination coverage through conduction of mass vaccination campaigns (supplementation to the routine activities) across different nations, yet more than 0.1 million children died worldwide from measles.[1] Further, outbreaks of measles in different parts of the world (such as India, Ethiopia) including developed nations, continue to pose a significant challenge to achieving the set targets.[1],[2]

In fact, in an attempt to bring about an improvement in the coverage of measles vaccine, the measles and rubella initiative was launched in 2001 in collaboration with various stakeholders.[6] Under the initiative, the target was to reduce measles deaths by 95% and ensure regional elimination of measles by 2015 and to achieve measles elimination in minimum five regions of the WHO by 2020.[2],[5] Further, depending on the recent estimates of measles coverage, the 2015 target will not be met, and there is a great need to take inspiration from those nations who have improved vaccination coverage predominantly because of the strengthening of the routine immunization components.[2]

However, if the world really wants to meet the proposed targets, there is an indispensable need to achieve and sustain high vaccination coverage with two doses of measles vaccine, supplementary immunization campaigns, strengthen the surveillance to ensure progress of vaccination activities (viz., attaining at least one of the two proposed surveillance indicators - nonmeasles febrile rash illness rate of at least two cases/0.1 million population/year and investigating at least one measles suspect case with blood specimens in at least 80% of districts per year for two successive years), developing a mechanism to maintain outbreak preparedness and utilizing the capacity which has been developed to contain poliomyelitis to avoid duplication of resources, involve members of the community to enhance the demand for vaccines, and invest in the research area to substantiate the implemented strategies.[1],[2],[7] At the same time, the policy makers should realize that measles can be eliminated, address the community barriers to improve the coverage, and strengthen the health systems to ensure equitable access to immunization services.[1],[2],[3],[4],[6]

To conclude, after taking major strides in an attempt to eliminate measles globally, the health sector cannot reduce the pace of efforts. The need of the hour is to have a coordinated approach under which routine immunization and surveillance activities are strengthened to eventually reduce the incidence and mortality associated with measles worldwide.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
World Health Organization. Measles – Fact Sheet No. 286; 2015. Available from: target="_blank" href="http://www.who.int/mediacentre/factsheets/fs286/en/". [Last accessed on 2015 Nov 08].  Back to cited text no. 1
    
2.
World Health Organization. Measles Vaccination has Saved an Estimated 17.1 Million Lives Since 2000; 2015. Available from: target="_blank" href="http://www.who.int/mediacentre/news/releases/2015/measles-vaccination/en/". [Last accessed on 2015 Nov 13].  Back to cited text no. 2
    
3.
Perry RT, Murray JS, Gacic-Dobo M, Dabbagh A, Mulders MN, Strebel PM, et al. Progress toward regional measles elimination- worldwide, 2000-2014. MMWR Morb Mortal Wkly Rep 2015;64:1246-51.  Back to cited text no. 3
    
4.
World Health Organization. Immunization Coverage – Fact Sheet No. 378; 2015. Available from: target="_blank" href="http://www.who.int/mediacentre/factsheets/fs378/en/". [Last accessed on 2016 Mar 14].  Back to cited text no. 4
    
5.
World Health Organization. Global Measles and Rubella Strategic Plan: 2012-2020. Geneva: WHO Press; 2012. p. 1-13.  Back to cited text no. 5
    
6.
Teleb N, Mohsni E. Progress towards measles elimination in the Eastern Mediterranean Region: Successes and challenges. East Mediterr Health J 2015;21:237-8.  Back to cited text no. 6
    
7.
Zuo S, Cairns L, Hutin Y, Liang X, Tong Y, Zhu Q, et al. Accelerating measles elimination and strengthening routine immunization services in Guizhou Province, China, 2003-2009. Vaccine 2015;33:2050-5.  Back to cited text no. 7
    




 

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