Home > Programmes > Measles Immunization
Reduce incidence of diarrhoea by promoting measles vaccination within the first year of a child’s life. 100% immunization coverage against measles is the programme goal.
|Name: Measles Immunization|
|Theme: Health Workers Education
||Region and Country: Maharashtra, India|
Children who have measles, or have had the disease in the previous 4 weeks, have a substantially increased risk of developing severe or fatal diarrhoea or dysentery (there is some evidence that the increased risk lasts up to months after the measles episode). Because of the strong relationship between measles and serious diarrhoea, and the effectiveness of measles vaccine, immunization against measles is a very cost-effective measure for reducing the morbidity and mortality associated with diarrhoea. Measles vaccine given at the recommended age can prevent up to 25% of diarrhoea-associated deaths in children under 5 years of age.
However, in India, there are still _____ percent of children who are not immunized against measles. A team of researchers will investigate the following key points related to why many (how many?) children are not receiving a measles immunization within the first year of their life.
Is there an adequate supply of the measles vaccination for all children within their first year of life in the state of Maharashtra? If so, is the necessary coordination occurring within the health delivery system to provide the vaccination to children within the first year of their life?
Are health care providers aware of the importance and necessity of a measles vaccination to all children to reduce child mortality, and the importance of receiving this immunization within the first year of a child's life? If so, are they effectively conveying this message to mothers?
Are mothers aware of the importance and necessity of a measles vaccination to all children within their first year of life, and if so what is the obstacle preventing children from receiving the vaccination in the time proposed?
Through a multi-tiered investigation of why all children are not receiving a measles immunization within the first year of their life, a programme will be designed to provide the vaccination to children. The programme aim will be to provide 100 % immunization coverage against measles to children within their first year of life
Programme Management and Implementation:
Health workers will play a crucial role in the anticipated social marketing of measles immunization for child survival. The health workers will serve as the "sales force" to sell the knowledge and importance of a measles vaccination within the first year of a child's life to mothers. In order to do this, they must be fully educated about the product they are promoting--its benefits and costs--and be sensitive to the concerns of mothers.
The knowledge gained from the investigation about why (how many) children are not currently being immunized against measles within their first year of life will be analyzed and applied to design a program increasing vaccination coverage. This programme will include a campaign that promotes a single day of the week for free measles vaccinations. Through demand creation activities such as TV and radio broadcasts, and print materials, mothers will be informed about the special opportunity on a designated day of the week for a free measles vaccination. This tactical information will be combined with a thematic message about the danger of measles. As part of this program, extended hours of local health centres will be advertised. Focusing a mother's attention on a specific day will encourage her to think about her child's immunization status and take action.
In addition to this campaign, conferences can be organized to effectively receive the increased demand for the measles vaccination. These conferences will serve as a way to mobilize health workers, but also allow them to express difficulties and resolve possible conflicts or problems that may arise with the increased demand of measles immunization. The conferences can also serve as a locale for distributing materials, explaining campaign rationales, and providing refresher training in immunization if necessary.
Programme Monitoring and Evaluation:
Health workers will be given the task of monitoring the design and implementation of the programme. Because they are the key player in this programme, they can be presented with the task of monitoring the program as an opportunity to monitor and evaluate the success of their campaign and its related activities.
Learning and Dissemination:
Online Q&A - April 2013
Q: What are some of the myths - and facts - about vaccination?
A: Myth 1: Better hygiene and sanitation will make diseases disappear - vaccines are not necessary. FALSE
Fact 1: The diseases we can vaccinate against will return if we stop vaccination programmes. While better hygiene, hand washing and clean water help protect people from infectious diseases, many infections can spread regardless of how clean we are. If people are not vaccinated, diseases that have become uncommon, such as polio and measles, will quickly reappear.
Myth 2: Vaccines have several damaging and long-term side-effects that are yet unknown. Vaccination can even be fatal. FALSE
Fact 2: Vaccines are very safe. Most vaccine reactions are usually minor and temporary, such as a sore arm or mild fever. Very serious health events are extremely rare and are carefully monitored and investigated. You are far more likely to be seriously injured by a vaccine-preventable disease than by a vaccine. For example, in the case of polio, the disease can cause paralysis, measles can cause encephalitis and blindness, and some vaccine-preventable diseases can even result in death. While any serious injury or death caused by vaccines is one too many, the benefits of vaccination greatly outweigh the risk, and many, many more injuries and deaths would occur without vaccines.
Myth 3: The combined vaccine against diphtheria, tetanus and pertussis (whooping cough) and the vaccine against poliomyelitis cause sudden infant death syndrome. FALSE
Fact 3: There is no causal link between the administering of the vaccines and sudden infant death, however, these vaccines are administered at a time when babies can suffer sudden infant death syndrome (SIDS). In other words, the SIDS deaths are co-incidental to vaccination and would have occurred even if no vaccinations had been given. It is important to remember that these four diseases are life-threatening and babies who are not vaccinated against them are at serious risk of death or serious disability.
Myth 4: Vaccine-preventable diseases are almost eradicated in my country, so there is no reason to be vaccinated. FALSE
Fact 4: Although vaccine preventable diseases have become uncommon in many countries, the infectious agents that cause them continue to circulate in some parts of the world. In a highly inter-connected world, these agents can cross geographical borders and infect anyone who is not protected. In western Europe, for example, measles outbreaks have occurred in unvaccinated populations in Austria, Belgium, Denmark, France, Germany, Italy, Spain, Switzerland and the United Kingdom since 2005. So two key reasons to get vaccinated are to protect ourselves and to protect those around us. Successful vaccination programmes, like successful societies, depend on the cooperation of every individual to ensure the good of all. We should not rely on people around us to stop the spread of disease; we, too, must do what we can.
Myth 5: Vaccine-preventable childhood illnesses are just an unfortunate fact of life. FALSE
Fact 5: Vaccine preventable diseases do not have to be 'facts of life'. Illnesses such as measles, mumps and rubella are serious and can lead to severe complications in both children and adults, including pneumonia, encephalitis, blindness, diarrhoea, ear infections, congenital rubella syndrome (if a woman becomes infected with rubella in early pregnancy), and death. All these diseases and suffering can be prevented with vaccines. Failure to vaccinate against these diseases leaves children unnecessarily vulnerable.
Myth 6: Giving a child more than one vaccine at a time can increase the risk of harmful side-effects, which can overload the child's immune system. FALSE
Fact 6: Scientific evidence shows that giving several vaccines at the same time has no adverse effect on a child's immune system. Children are exposed to several hundred foreign substances that trigger an immune response every day. The simple act of eating food introduces new antigens into the body, and numerous bacteria live in the mouth and nose. A child is exposed to far more antigens from a common cold or sore throat than they are from vaccines. Key advantages of having several vaccines at once is fewer clinic visits, which saves time and money, and children are more likely to complete the recommended vaccinations on schedule. Also, when it is possible to have a combined vaccination, e.g. for measles, mumps and rubella, that means fewer injections.
Myth 7: Influenza is just a nuisance, and the vaccine isn't very effective. FALSE
Fact 7: Influenza is much more than a nuisance. It is a serious disease that kills 300 000-500 000 people worldwide every year. Pregnant women, small children, elderly people with poor health and anyone with a chronic condition, like asthma or heart disease, are at higher risk for severe infection and death. Vaccinating pregnant women has the added benefit of protecting their newborns (there is currently no vaccine for babies under six months). Vaccination offers immunity to the three most prevalent strains circulating in any given season. It is the best way to reduce your chances of severe flu and of spreading it to others. Avoiding the flu means avoiding extra medical care costs and lost income from missing days of work or school.
Myth 8: It is better to be immunized through disease than through vaccines. FALSE
Fact 8: Vaccines interact with the immune system to produce an immune response similar to that produced by the natural infection, but they do not cause the disease or put the immunized person at risk of its potential complications. In contrast, the price paid for getting immunity through natural infection might be mental retardation from Haemophilus influenzae type b (Hib), birth defects from rubella, liver cancer from hepatitis B virus, or death from measles.
Myth 9: Vaccines contain mercury which is dangerous. FALSE
Fact 9: Thiomersal is an organic, mercury-containing compound added to some vaccines as a preservative. It is the most widely-used preservative for vaccines that are provided in multi-dose vials. There is no evidence to suggest that the amount of thiomersal used in vaccines poses a health risk.
Myth 10: Vaccines cause autism FALSE
Fact 10: The 1998 study which raised concerns about a possible link between measles-mumps-rubella (MMR) vaccine and autism was later found to be seriously flawed, and the paper has been retracted by the journal that published it. Unfortunately, its publication set off a panic that led to dropping immunization rates, and subsequent outbreaks of these diseases. There is no evidence of a link between MMR vaccine and autism or autistic disorders.
Impact of Vaccines in the 20th & 21st Centuries
Comparison of 20th Century Annual Morbidity & Current Morbidity
How Vaccines Have Changed Our World In One Graphic
vaccine infographic created by Leon Farrant
Data from the web site of the Centers for Disease Control & Prevention repesent data collected in 2007 on past incidence of these diseases. This was published here, in the Journal of the American Medical Association. The current data are annualized cases for 2010, per the link to the original data that I had included above.
Notes from the Field: Communication for Child Survival, Launching a Social Marketing Project for Immunization in Metro Manila by Eleanora M. de Guzman, Cecilia Cabanero-Verzosa, Jose Rafael S. Hernandez, et. al (87-94).
Facts for Life - Measles Immunization
Management of a Child with Measles
Dr. Anil Mokashi. MD., DCH., FIAP, PhD.
GAVI Alliance: Saving children's lives and protecting people's health by increasing access to immunisation in poor countries - With GAVI Alliance support, developing countries are making important progress in introducing life-saving vaccines faster than ever before.