Recent studies suggest that infants are susceptible to measles three months after birth, rather earlier than the previously believed six months. The novel research points out that maternal antibodies, that fight against measles, disappear at the end of three months. With the first dose of measles vaccination being given only at 9-12 months in countries like India, where measles transmission is still a challenge and at 12-15 months in countries with no ongoing transmission, this leaves a vulnerable window for infants becoming susceptible to measles before they receive vaccination.
The Burden of Measles
In 2018, an estimated 10 million measles cases and about 1,42,000 deaths were reported worldwide. During 2018-2019, nearly 72,000 cases were reported in India, making it the third-highest in the world. India, with 2.3 million children unvaccinated against measles, stands at the second-highest position after Nigeria. Although the number reduced from 2.9 million in 2017 to 2.3 million in 2018, the reduction rate is not enough to eliminate the disease.
Vaccination Coverage and Its Importance
The World Health Organization (WHO) stresses on the high coverage (over 95%) of two doses of measles-containing vaccine for protecting infants from measles. However, the global figures of 2018 reveal that only 86% of children received the first dose and a mere 69% received the second dose. Vaccinating earlier than recommended causes lesser vaccine-induced protection in infants. It also may “alter response” after the second dose, leading to lower levels of the antibody compared to children vaccinated as per schedule.
Why Can’t Pregnant Mothers Be Vaccinated?
Since the measles vaccine contains live and weakened virus, it cannot be administered to pregnant mothers. After injection, the weakened or live virus may cause infection in the person’s body.
| Year | Estimated measles cases globally | Deaths due to measles globally |
|---|---|---|
| 2018 | 10 million | 1,42,000 |
Threshold Level of Protection and Maternal Age
In India, where many mothers gain immunity through natural infection and are also frequently exposed to the virus, “repeated immunologic boosting and robust antibody levels” occur. On the other hand, infants born in countries with eliminated measles virus have lower maternal antibodies that fall below the threshold of protection before they receive their first vaccine dose. Additionally, the probability of infants getting infected increases with maternal age.
Government Initiatives in India
The Ministry of Health and Family Welfare initiated the Measles-Rubella (MR) vaccination program in 2017. Targeting about 41 crore children countrywide, it’s the largest campaign ever. All children aged from 9 months to less than 15 years will be given a single shot of MR vaccination, irrespective of their previous vaccination status or disease status. Other initiatives include Universal Immunization Programme (UIP), Mission Indradhanush, and Intensified Mission Indradhanush.
Details About Measles
An enveloped, ribonucleic acid virus of the genus Morbillivirus causes measles. It is highly contagious and an affected person can transmit the virus to over 90% of unprotected close contacts. The virus infects the respiratory tract and then spreads throughout the body. It is exclusively a human disease. Cases of measles in animals haven’t been recorded. Measles can be prevented entirely through a two-dose vaccine. The first dose of the measles vaccine was introduced in the 1990s in India, with the second dose being added only from 2010 onwards.
Treatment for Measles
Currently, there is no specific antiviral treatment for measles virus infection. Complications can be avoided through medical care ensuring good nutrition, adequate fluid intake, and necessary treatment of dehydration. Advanced healthcare systems have managed to officially eliminate measles in many countries.
