New Delhi: At 16 lakh, India has the highest number of children who have not been administered the measles vaccine in 2023 after Nigeria and the Democratic Republic of Congo, according to the World Health Organisation-United Nations International Children’s Emergency Fund estimates of the national immunisation coverage, released Monday.
The report said India is among 10 countries that account for 55 percent of children without measles vaccine globally, indicating that the proportion of vaccinated kids in India stands between 90-94 percent in 2023.
“The countries with most ‘measles zero dose’ children are a mix of those with large birth cohorts, weak health systems, or both,” said the report.
Measles, a vaccine-preventable viral disease, affects young children the most. It has typical flu-like symptoms with characteristic rashes all over the body. In severe cases, it causes pneumonia and inflammation of the brain in young kids, which can prove fatal.
The latest figures come against the backdrop of India reporting a measles outbreak in at least five states in 2022, mainly due to a drop in vaccination coverage for vulnerable kids during the COVID-19 pandemic years, with Maharashtra reporting the highest number of cases and deaths due to measles.
With this, India has recorded more ‘measles zero dose’ children in 2023 than in 2022, when it stood at 11 lakh.
ThePrint emailed the Union health ministry for its response on the new missed vaccination numbers. This copy will be updated if and when a reply is received.
Under the Centre’s Universal Immunization Programme (UIP), a vaccine against measles is now offered in a combination vaccine, including rubella vaccine (MR), which comes in two shots, the first at 9-12 months and the second at 16-24 months. Meanwhile, the vaccine against measles is available as the Mumps Measles Rubella (MMR) vaccine in the private sector.
According to experts, while the case fatality rate due to the disease is 1-3 percent, it can be as high as 5-10 percent during an outbreak. Additionally, India has the second-highest number of kids without the first dose of combination vaccines against three infectious diseases, diphtheria, pertussis, and tetanus (DPT-1), in 2023. This vaccine is offered to all kids at six weeks of age under the UIP.
The WHO-UNICEF report has also revealed that globally, nearly 1.4 crore children missed the immunisation in 2023.
“A key goal of the Immunisation Agenda 2030 (IA2030) is to reduce the number of zero-dose children by half by 2030. Actual achievements show that the 2022 estimate of zero-dose children is still slightly above 2019 (pre-pandemic) levels; global coverage has not fully recovered from pandemic disruptions and is not yet on track to achieve that 2030 target,” the health body said.
IA2030 aimed to reduce the number of zero-dose children by half by 2030.
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Missed measles elimination deadlines
In 2019, India, jointly with other countries in the WHO South-East Asia Region, adopted the goal of measles and rubella elimination by 2023, a revision of the previous goal of measles elimination and control of rubella and congenital rubella syndrome by 2020.
After an assessment that nearly 75 percent of the districts were far from the elimination target, the government deferred the deadline again but is yet to set a new one.
“We need to analyse micro-level MR vaccination coverage data and develop a fresh district-level strategy to achieve elimination of the disease,” Dr T. Jacob John, co-chair of the India Expert Advisory Group on Measles & Rubella (IEAG-MR), told ThePrint.
After the 2022 measles outbreak, the Union health ministry ran a catch-up measles outbreak response and immunisation campaign. It covered kids of two to five years of age in 16 states, including Uttar Pradesh, Bihar, Jharkhand, Maharashtra, Gujarat, Rajasthan and West Bengal.
In December 2023, the ministry also issued a statement, saying the Intensified Mission Indradhanush (catch-up vaccination campaign) offered the vaccine to all unvaccinated or partially vaccinated children with missed or due doses of vaccines.
The government ran another campaign in 2023, aiming to increase the coverage of the MR vaccine in children up to the age of 5 years.
At the time, the Centre said several states carried out supplementary immunisation activities and outbreak response immunisation, vaccinating 30 million children with an additional MR vaccine dose.
(Edited by Madhurita Goswami)
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