Administer additional dose of measles, rubella vaccines to children in vulnerable areas: Centre to states, UTs

Amid an increase in the number of measles cases, the Ministry of Health and Family Welfare Wednesday asked states and Union Territories to administer one additional dose of measles and rubella vaccines to all children, aged 9 months to 5 years, in vulnerable areas.
The directions came after a meeting of Domain Knowledge Technical Experts held under the chairpersonship of member (Health), NlTl Aayog, to review the situation.

“Administering one additional dose of Measles and Rubella Containing Vaccines (MRCVs) to all children aged 9 months to 5 years in vulnerable areas (geographies which are showing recent increase in numbers of measles cases) should be identified by the state government/UT administration in ‘Outbreak Response immunisation (ORl)’ mode,” said the order issued by the ministry.

The special dose will be in addition to the primary vaccination schedule – first dose at 9-12 months and the second dose 16-24 months.

The ministry also instructed states and UTs to administer one dose of MRCVs to all children aged 6 months to 9 months in those areas where measles cases in the age group are above 10 percent of the total cases.

Recently, an upsurge in measles cases were reported from certain districts of Bihar, Gujarat, Haryana, Jharkhand, Kerala and Maharashtra.

Areas under Brihanmumbai Municipal Corporation (BMC) and some other districts in Maharashtra have reported a rapid rise in infections and 10 mortalities caused by the measles virus.

According to the ministry, in all such geographies, the affected children were predominantly unvaccinated and the average coverage of MRCVs among the eligible beneficiaries is significantly below the national average.

Directions have also been issued to states and UTs to ensure an active fever and rash surveillance mechanism to strengthen early case identification.

“Headcount of all children aged 6 months to 5 years must be undertaken in the vulnerable/outbreak areas to facilitate full MRCV coverage in an accelerated manner. The institutionalised mechanism of the ‘District Task Force’ on immunisation under the chairmanship of the district collector must be activated to review the measles situation on a daily/weekly basis and plan the response activities accordingly,” the ministry added.

As part of the case identification and management, the states have been asked to ensure house to house search activities to identify affected children.

The states have also been asked to earmark wards and beds for effective caseload management of measles cases in dedicated health facilities for timely transfer and treatment of such children.

“Immediate isolation of laboratory confirmed cases must be done in at least 7 days from the date of identification. Guidance for home-based care of such cases must be issued with reference to age-appropriate two doses of vitamin A supplementation with adequate nutritional support. Caregivers must be made aware of danger signs for immediate hospitalisation of children, i.e., persistent diarrhoea, rapid breathing with chest indrawing (pneumonia) and ear discharge,” the order issued by the ministry added.

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