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Post-campaign coverage evaluation of a measles and rubella supplementary immunization activity in five districts in
Jeromie Wesley Vivian Thangaraj1, Christine Prosperi2, Muthusamy Santhosh Kumar1
1Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Epidemiology Chennai, Chennai, India.
Insights
India
Area of Science:
- Public Health
- Epidemiology
- Vaccinology
Background:
- India's Measles and Rubella (MR) Strategic Elimination plan guided a nationwide vaccination campaign (2017-2020).
- The campaign aimed to administer MR vaccine to children aged 9 months to 15 years.
- This study evaluated campaign coverage, awareness, and associated factors in five Indian districts.
Purpose of the Study:
- To estimate measles and rubella vaccination campaign coverage in five Indian districts.
- To assess campaign awareness among caregivers.
- To identify factors associated with vaccination status during the campaign.
Main Methods:
- Community-based cross-sectional serosurveys were conducted post-campaign.
- Coverage was determined using immunization records or caregiver recall.
- Descriptive analyses identified reasons for vaccine non-receipt and associated risk factors.
Main Results:
- Campaign coverage for children aged 9 months to 5 years ranged from 74.2% to 90.4% across districts.
- Caregiver awareness was high (88.3%-97.6%), yet 8% of aware individuals' children remained unvaccinated.
- Lower coverage was linked to urban settings, low maternal education, and non-school attendance.
Conclusions:
- Despite high awareness, MR campaign coverage fell short of the 95% elimination target in all studied districts.
- Districts with lower coverage, particularly among younger children, require focused interventions.
- Strengthening routine immunization and targeted strategies are crucial for reaching under-vaccinated populations.
Background:
In alignment with the Measles and Rubella (MR) Strategic Elimination plan, India conducted a mass measles and rubella vaccination campaign across the country between 2017 and 2020 to provide a dose of MR containing vaccine to all children aged 9 months to 15 years. We estimated campaign vaccination coverage in five districts in India and assessed campaign awareness and factors associated with vaccination during the campaign to better understand reasons for not receiving the dose.
Methods And Findings:
Community-based cross-sectional serosurveys were conducted in five districts of India among children aged 9 months to 15 years after the vaccination campaign. Campaign coverage was estimated based on home-based immunization record or caregiver recall. Campaign coverage was stratified by child- and household-level risk factors and descriptive analyses were performed to assess reasons for not receiving the campaign dose. Three thousand three hundred and fifty-seven children aged 9 months to 15 years at the time of the campaign were enrolled. Campaign coverage among children aged 9 months to 5 years documented or by recall ranged from 74.2% in Kanpur Nagar District to 90.4% in Dibrugarh District, Assam. Similar coverage was observed for older children. Caregiver awareness of the campaign varied from 88.3% in Hoshiarpur District, Punjab to 97.6% in Dibrugarh District, Assam, although 8% of children whose caregivers were aware of the campaign were not vaccinated during the campaign. Failure to receive the campaign dose was associated with urban settings, low maternal education, and lack of school attendance although the associations varied by district.
Conclusion:
Awareness of the MR vaccination campaign was high; however, campaign coverage varied by district and did not reach the elimination target of 95% coverage in any of the districts studied. Areas with lower coverage among younger children must be prioritized by strengthening the routine immunization programme and implementing strategies to identify and reach under-vaccinated children.
