Reactogenecity of indigenously produced measles vaccine.

OBJECTIVE: To assess the safety and reactogenecity of indigenously produced measles vaccine derived from EZ strain. DESIGN: A longitudinal clinical follow up after vaccination. SETTING: Hospital based and home follow up, as required. SUBJECTS: 12,470 children, 9 to 15 months old, immunized with measles vaccine of EZ strain, in accordance with the National Immunization Schedule, at five centers. METHODS: A clinical follow up of children at 1 day, 1 week, 2 weeks, 3 weeks and 6 weeks after measles vaccination. A detailed clinical neurological examination in children showing side effects. RESULTS: Mild side effects were documented in 31%. Of these, 90% were seen in the first two weeks, out of which two thirds were seen during the first week. Commonest side effects were coryza (10%), fever (9.8%), cough (3.2%) and diarrhea (3.2%). Convulsions, with no later sequelae were documented in 2 cases only. CONCLUSIONS: Measles vaccine manufactured in India, using EZ strain is a safe vaccine. It has a level of reactogenecity including neurological aspects, lower than that reported in India with the Schwarz strain vaccine.

Serum adenosine deaminase estimation in relation to BCG vaccination.

Serum adenosine deaminase (ADA) levels reflect activity of stimulated T lymphocytes and its levels are raised whenever cell mediated immunity is stimulated. One hundred term normal newborns were studied to evaluate effect of BCG vaccination on serum ADA levels. Serum ADA was measured at birth and 6 weeks after BCG vaccination. Only 67 subjects came for follow up after 6 weeks. The levels were 6.69 U/litre at birth and 13.83 U/litre after 6 weeks of vaccination showing a significant rise. It is concluded that serum ADA levels can be used as a measure of cell mediated immunity after BCG vaccination.

Immunogenicity and reactogenicity of indigenously produced MMR vaccine.

OBJECTIVES: To study immunogenicity and reactogenicity of indigenously produced MMR vaccine and to assess the booster effect of MMR immunization on measles seroconversion. DESIGN: A longitudinal follow up. SETTING: Hospital based and home follow up, as required. SUBJECTS: 89 children already immunized for measles, between 15 to 24 months of age for immunogenic evaluation and 866 subjects for the reactogenic component. METHODS: Prevaccination and postvaccination samples collected one and four weeks after vaccination were studied by ELISA for IgG and IgM antibodies against the three diseases. A clinical follow up of immunized children was done at 3 days, 7 days, 6 weeks and 6 months after immunization. RESULTS: IgG positivity 4 weeks after immunization rose from 75% to 100% for measles, from 12% to 92% for mumps, and from 13% to 99% for rubella. Only mild side effects including pain and swelling in 37 (4.3%) cases, mild fever in 51 (5.9%) cases, cough in 40 (4.6%) cases and a transient rash in 7 (0.8%) cases were observed. CONCLUSIONS: The indigenously manufactured MMR vaccine has an excellent immunogenicity and low reactogenicity with a booster effect for measles seroconversion in children already immunized for this disease.

Utilization of ICDS scheme in children one to six years of age in a rural block of central India.

The evaluation of nutritional and immunization services was undertaken in the rural ICDS block Sanwer (Madhya Pradesh) where the project is functioning from last 3 years. A door to door survey was conducted in 1993 in six Anganwadi areas in ICDS block and five randomly selected matched non ICDS rural area served as controls. There were a total of 709 children in ICDS and 500 in non ICDS block in 1-6 years age group. The difference was not statistically significant for nutritional status in the two blocks, but a remarkably better immunization status (p < 0.005) was observed in non ICDS block. The coverage for DPT (3 doses), and measles vaccination in ICDS block was 79.57% and 45.7%, respectively, while in non ICDS block it was 94.4% and 62.03%, respectively. It seems the ICDS scheme is under utilized by the community and requires immediate attention by the health authorities.