Introduction
This is a mass vaccination campaign to be conducted in Maharashtra state to introduce Measles-Rubella vaccine. This program targets a wide range of age group of children from 9 months to less than 15 years. In this campaign, all the children in the target age group will receive vaccine regardless of their previous vaccination status or history of illness.
What is Measles? :-
Measles is highly infectious, potentially fatal disease which affects children. Measles is caused by a specific virus of the group myxoviruses. The signs and symptoms of measles disease are high fever, cough, coryza, and conjunctivitis. The typical maculopapular rash appears 3–4 days after the prodrome with a high fever peaking at 39– 40°C. The rash spreads from the face and neck to the trunk and extremities, fading after about 3 days. The average interval from exposure to onset of rash is 14 days (range 7–18 days). There is no other reservoir for measles virus except the human being. The virus only survives in human beings. An effective vaccine which can prevent the children from getting measles is available.
Complications of measles are associated with children particularly less than 5 years of age which may result in death. Complications include otitis media (5–15%) and pneumonia (5–10%). In poor living condition, persistent diarrhea with protein-losing enteropathy may ensue, particularly in young infants.
What is Rubella? :-
Rubella is also a respiratory group of viral disease is caused by Togavirus infection. The symptoms of Rubella include maculopapular rash, fever, coryza, sore throat, and lymphadenopathy. In adults, the characteristic symptoms are lymphadenopathy and arthritis/arthralgia which are more pronounced. The period of infectivity in rubella is 7 days before to 7 days after onset of rash.
If rubella occurs in the female during early pregnancy period, the virus may infect placenta along with the fetus causing Congenital Rubella Syndrome. CRS usually manifests with congenital cataract, congenital glaucoma, congenital deafness, congenital cardiac defects like ventricular septal defects, atrial septal defects, patent ductus arteriosus, hepatosplenomegaly, microcephaly, hematological disorders like purpura and often having mental retardation due to suboptimal brain tissue development. There is no specific treatment for rubella and the disease can be only prevented through immunization.
Measles-rubella (MR) vaccine:-
The Measles-rubella (MR) vaccine which is used in the immunization programme is the live attenuated vaccine. This vaccine is safe and effective for the prevention of measles and rubella disease. Measles vaccines are available either as single antigen vaccines or in combination with either rubella (MR) or mumps and rubella (MMR) vaccines and with mumps, rubella and varicella (MMRV) vaccine. When MR / MMR / MMRV vaccines are used, the protective immune response to each of the components remains unchanged.
Who to be vaccinated:-
All children in the target age group (9 months to 15 years) are vaccinated irrespective of previous immunization status or history of measles/rubella disease
- All the school going children will be vaccinated through school
- All the non-school going children will be covered through Anganwadi centers and Primary health centers.
Adverse reactions to MR vaccine:-
- Adverse reactions to MR vaccine are mild and occurs to very few of the vaccinated children
- Slight pain and tenderness at the site of injection may occur within 24 h, sometimes followed by mild fever
- About 7–12 days after vaccination, up to 5% of measles vaccine recipients may experience fever
- The transient rash may occur in about 2% of vaccinated children
Contraindications to MR vaccine:-
- High-grade fever (>102 °F / 38–39 °C)
- serious disease or pregnancy
- History of an anaphylactic reaction to neomycin, gelatin
- severely immune-compromised as a result of congenital disease, HIV infection (full-blown AIDS), advanced leukemia or lymphoma, serious malignant disease, receiving immunosuppressive therapeutic radiation
Following are not contraindications for MR vaccination:-
Minor illness like mild respiratory infection, diarrhea and low-grade fever for less than 3 days
Malnutrition
Asymptomatic HIV-infected children
