Immunogenicity of measles-rubella vaccine administered under India’s Universal Immunization Programme in the context of measles rubella elimination goal: A longitudinal study

Background & objectives: There is a paucity of data regarding immunogenicity of recently introduced measles–rubella (MR) vaccine in Indian children, in which the first dose is administered below one year of age. This study was undertaken to assess the immunogenicity against rubella and measles 4-6 wk after one and two doses of MR vaccine administered under India’s Universal Immunization Programme (UIP). Methods: In this longitudinal study, 100 consecutive healthy infants (9-12 months) of either gender attending the immunization clinic of a tertiary care government hospital affiliated to a medical college of Delhi for the first dose of routine MR vaccination were enrolled. MR vaccine (0.5 ml, subcutaneous) was administered to the enrolled participants (1st dose at 9-12 months and 2nd dose at 15-24 months). On each follow up (4-6 wk post-vaccination), 2 ml of venous blood sample was collected to estimate the antibody titres against measles and rubella using quantitative ELISA kits. Seroprotection (>10 IU/ml for measles and >10 WHO U/ml for rubella) and antibody titres were evaluated after each dose. Results: The seroprotection rate against rubella was 97.5 and 100 per cent and against measles was 88.7 per cent and 100 per cent 4-6 wk after the first and second doses, respectively. The mean (standard deviation) titres against rubella and measles increased significantly (P<0.001) after the second dose in comparison to the levels after the first dose by about 100 per cent and 20 per cent, respectively. Interpretation & conclusions: MR vaccine administered below one year of age under the UIP resulted in seroprotection against rubella and measles in a large majority of children. Furthermore, its second dose resulted in seroprotection of all children. The current MR vaccination strategy of two doses, out of which the first is to be given to infants below one year of age, appears robust and justifiable among Indian children.

Epidemiological study to assess the status of measles vaccination in under five children and factors associated, in a peri-urban area, Asudgaon village, in Raigad district, Maharashtra, India

Background: Measles continues to be a major cause of childhood morbidity and mortality in India. Measles is considered one of the leading vaccine-preventable causes of child mortality worldwide. Major reasons for low vaccine coverage exist within the health care system itself, which creates barriers to obtaining immunization. Materials and Methods: A cross-sectional, descriptive, epidemiological study that aimed to examine the coverage of measles vaccination among under-five children of Asudgaon village. All under-five children residing in every 5th household of the village were included(n = 445). After obtaining consent from the mother, data was collected from her using a pre-designed and pre-tested questionnaire. The data was entered and analyzed in SPSS 23. Results: There was a total of 100 children eligible for the study. Overall, 41% of children were fully immunized against measles, 37% were partially immunized, 5% were immunized to date and 17% were not immunized. The most reasons for partial or non-immunization for measles were inadequate knowledge about immunization (19%), unawareness of days of vaccination(n = 14%), the child being ill at the time of vaccination, husband or mother-in-law against vaccination, fear of effects, and others. The Chi-square test indicates a significant association between mothers’ education and measles vaccination. Conclusion: Immunization status needs to be improved through education, increasing awareness, and counseling of parents regarding immunization and associated misconceptions as observed in the study.

Spatial Mapping of Measles-Rubella Campaign in a Rural Area near Bengaluru, Karnataka, India

Immunization is animportant public health intervention.The Measles-Rubella (MR) campaign was launched during 2017in India for the elimination of measles.This study explored vaccination coverageandspatialmapping using QGIS and Google Earth Pro. WHO-EPI30 clusters sampling technique for evaluation of vaccination coverage was performed in villages within the rural area of a Medical College nearBengaluru.Seven children aged 2-15 years were surveyed per cluster, resulting in 210 children. Smartphones having GPS/Garmin GPS72H (handheld GPS receiver)were used for noting coordinates. Subsequently all these coordinates were plottedfor spatial mapping of vaccination coverage. The geospatial characteristics of the households surveyed were described using spatial mapping. Results indicate that 87.6% were immunized with MR Vaccine under the campaign, but 12.4% remained unimmunized, the reasons given being absence, ignorance, or refusal because of rumours concerning side-effects.The Measles-Rubella campaign coverage was found to be satisfactory. In addition the spatial mapping is a useful tool for measurement of coverage of a vaccination campaign. There was no clustering of unimmunized subjects observed on spatial mapping.