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To the Editor: Measles remains an important global health problem, especially among under-five children. Measles infects over 6 million people every year and kills 300 children each day. The disease burden of measles is high due to its higher infectivity (R0 value: 12 to 18) and associated complications like encephalitis, pneumonia, diarrhea, and otitis media [1]. Measles vaccination resulted in a 73% drop in measles deaths between 2000 and 2018 worldwide. Attaining and maintaining more than 95 per cent coverage will give the herd immunity and result in the elimination of disease [2].
The present measles outbreak mainly involved children aged 9 mo to 15 y (93%) with the maximum cases occurring in the age group 1–4 y (40%). India is the capital of the recent outbreak of measles in the world. There were 172 confirmed measles outbreaks from October 2021 to September 2022, with a total no. of cases of 12,589 [3]. As per the NFHS-5 (2019–2021) data, 87.9% of children aged 12–23 mo received the first dose of the measles-containing vaccine, whereas only 31.9% of children aged 24–35 mo received the second dose of the measles-containing vaccine. The recent COVID-19 outbreak severely dented the vaccination coverage that has been achieved over the past few years.
The Measles–Rubella (MR) 2020 program had the goal to eliminate measles by 2020, but due to the COVID-19 outbreak, it was revised to 2023 [4]. Looking at the recent outbreaks and NFHS-5 data on vaccination coverage, we are nowhere close to our goal. Various shortcomings include paucity of manpower and communication, cold chain maintenance, difficult-to-reach areas, faulty surveillance, an insufficient and poor-quality lab network, vaccine hesitancy, and adverse events. Increased vaccine coverage by routine immunization and supplementary immunization activities, outbreak and emergency preparedness, robust and quality surveillance, and research and innovation are key strategies to achieve a measles-free world.
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Gastañaduy PA, Goodson JL, Panagiotakopoulos L, Rota PA, Orenstein WA, Patel M. Measles in the 21st century: progress toward achieving and sustaining elimination. J Infect Dis. 2021;224:S420–8.
Measles and Rubella Surveillance bulletin, WHO Country Office for India for Ministry of Health and Family Welfare. Sep 2022.
Ministry of Health and Family Welfare, Govt. of India. Universal Immunization Program. Available at: https://main.mohfw.gov.in/sites/default/files/Universal.pdf. Accessed on 10 Dec 2022.
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Kumar, A., Das, S. & Tripathy, S.K. Measles Elimination in India—Shifting Goal Post. Indian J Pediatr 90, 420 (2023). https://doi.org/10.1007/s12098-023-04494-z
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DOI: https://doi.org/10.1007/s12098-023-04494-z