Kerala - Thiruvananthapuram   

One more dose of vaccine to be routine in State for measles

Thiruvananthapuram: The Health Department will include a second dose of measles vaccination when children complete 18 months of age in its routine immunisation schedule as part of a national strategy to bring down the incidence of the infection.

At present, only a single dose is administered to infants free of cost at nine months, as part of the Universal Immunisation Programme (UIP).

Demand

While the policy decision to administer the second dose follows a directive from the Union Health and Family Welfare Ministry, paediatricians have demanded that the State government opt for the MMR (mumps, measles and rubella) vaccine as protection against rubella infection rather than just a second dose of the measles vaccination.

The demand for the MMR vaccine has now put the Health Department in a fix because a budgetary allocation of approximately Rs.3 crore will be required to give free MMR vaccination to 5.5 lakh children born in the State every year.

Funding

“The measles vaccine required for the second round of vaccination will be procured and supplied by the Union Ministry. Kerala can take the decision to opt for the MMR vaccine in its routine immunisation schedule instead of the second measles dose. But the Centre has made it clear that we will have to find our own funds for this,” P.K. Jameela, Additional Director for Health Services (Health and Family Welfare), says.

Delhi, Goa, Puducherry and Sikkim have included the MMR vaccine in their routine immunisation schedule, using State funds.

The MMR vaccine has been available in the country since 1985, but it is not part of the UIP. The vaccine is currently being administered by paediatricians in the private sector to infants between 12 and 18 months of age.

A large number of doctors in public sector hospitals are recommending the vaccine. However, total coverage by the vaccine cannot be ensured unless it is made part of routine immunisation.

The measles vaccine coverage in Kerala is about 88 percent. But the measles surveillance network in the State observed that the effect of this vaccination seems to wane by the time the child crosses the age of 10.

Rubella cases

In 2008, there were 3,288 cases of measles and three deaths.

In 2009, these were 3,765 and three, respectively, and till September 10 in 2010, 2,521 and six.

“In 2008 and 2009, a lot of so-called measles outbreaks reported in the State turned out to be actually rubella outbreaks, a senior Health official said.

Rubella is a mild viral disease which manifests as fever with rashes. In adults, it lasts barely three days. But it is most dangerous for pregnant women, especially if they contract the infection in the first trimester of pregnancy, as infants born to them can have multiple birth defects.

Officials' stance

Health officials have decided to combine their might to persuade the government into finding funds for including the MMR vaccine in the State's routine immunisation schedule.

However, till that comes through, the second dose of measles vaccination will have to be good enough.

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