Measles- Vaccination and WHO’s measles elimination strategy
Measles vaccine :
Type:
- Live attenuated, lyophilized (Freeze dried) vaccine
Strains used:
- Edmonston Zagreb Strain (Most Common)
- Schwartz Strain
- Moraten Strain
Dose:
- 0.5 ml
Route:
- Subcutaneous
Site:
- Antero-lateral aspect of thigh (middle one-third)
- Age of administration in National Immunisation schedule (India):
- India started 2-dose vaccination strategy for measles
- 9 months (can be lowered to 6-9 months in epidemics & malnutrition)
- Second dose of measles is also given at 16-24 months.
Diluent for Reconstitution:
- Distilled Water or sterile water
- Use within 1hr after reconstitution with diluent
- Side effectMeasles vaccine is contraindicated in pregnancy
- Measles (& MMR) vaccine can lead to Toxic Shock Syndrome
Measles vaccine also contains:
- Sorbitol and hydrolyzed gelatin as stabilizers
- Small amount of neomycin as preservative
- People with a history of an anaphylactic reaction to neomycin, gelatin or other components of the vaccine should not be vaccinated
In epidemics :
- Vaccine is to be given within 3 days of exposure
- Cold chain Temperature for storage: +2 to +8 degree C
- Protective efficacy: > 95%
- Duration of Protection: Lifelong
- IP of vaccine-induced measles: 7 days
Immunoglobulin
- Measles immunoglobulin is also available for post exposure prophylaxis.
- Non immunized pregnant women coming in contact with measles may be protected by:
- Intramuscular injection of 5ml of immune serum globulin within 3 days of exposure.
Elimination
- WHO defines elimination of measles as the absence of endemic measles for a period of 12 months in the presence of adequate surveillance.
- One indicator of measles elimination is a sustained measles incidence < 1/100, 000 population.
In 2005, the World Health Assembly set a goal:
- Achieving a 90% reduction in global measles mortality by 2010 as compared with level in 2000.
- WHO’s measles elimination strategy comprises a three part vaccination strategy, i.e. :–
i) Catch-up
- One-time, nationwide vaccination campaign targeting usually all children aged 9 months to
- 14 years regardless of history of measles disease or vaccination status.
ii) Keep-up
- Routine services aimed at vaccinating more than 95% of each successive birth cohort.
iii) Follow-up
- Nationwide vaccination every 2-4 years
Epidemic of measles :
- Occur if proportion of susceptible children is > 40%
- Measles is introduced in a virgin community, it infects > 90% of children
- Vaccination age can be lowered to 6 months in epidemics.
- Measles shows a cyclic trend with epidemic every 2-3 years.
- Eradication of measles requires vaccine coverage >95%
2010 World Health Assembly
- Following targets to be met by 2015 as milestones towards eventual global measles eradication :
- Raise routine coverage with the first dose of measles vaccine to . 90% nationally and 80% in every district
- Reduce and maintain annual measles incidence to < 5 cases per million
- Reduce measles mortality by 95% in comparison with estimated level in the year 2000.
Exam Important
Measles vaccine :
Type:
- Live attenuated, lyophilized (Freeze dried) vaccine
Route:
- Subcutaneous
Age of administration in National Immunisation schedule (India):
- India started 2-dose vaccination strategy for measles
- 9 months (can be lowered to 6-9 months in epidemics & malnutrition)
- Second dose of measles is also given at 16-24 months.
Diluent for Reconstitution:
- Distilled Water or sterile water
- Use within 1hr after reconstitution with diluent
- Side effectMeasles vaccine is contraindicated in pregnancy
- Measles (& MMR) vaccine can lead to Toxic Shock Syndrome
Measles vaccine also contains:
- Sorbitol and hydrolyzed gelatin as stabilizers
- Small amount of neomycin as preservative
- People with a history of an anaphylactic reaction to neomycin, gelatin or other components of the vaccine should not be vaccinated
In epidemics measles:
- Vaccine is to be given within 3 days of exposure
- Duration of Protection: Lifelong
- IP of vaccine-induced measles: 7 days
Immunoglobulin
- Measles immunoglobulin is also available for post exposure prophylaxis.
- Non immunized pregnant women coming in contact with measles may be protected by:
- Intramuscular injection of 5ml of immune serum globulin within 3 days of exposure.
Elimination
- WHO defines elimination of measles as the absence of endemic measles for a period of 12 months in the presence of adequate surveillance.
- One indicator of measles elimination is a sustained measles incidence < 1/100, 000 population.
- In 2005, the World Health Assembly set a goal:
- Achieving a 90% reduction in global measles mortality by 2010 as compared with level in 2000.
- WHO’s measles elimination strategy comprises a three part vaccination strategy, i.e. :–
i) Catch-up
- One-time, nationwide vaccination campaign targeting usually all children aged 9 months to
- 14 years regardless of history of measles disease or vaccination status.
ii) Keep-up
- Routine services aimed at vaccinating more than 95% of each successive birth cohort.
iii) Follow-up
- Nationwide vaccination every 2-4 years
Epidemic of measles :
- Occur if proportion of susceptible children is > 40%
- Measles is introduced in a virgin community, it infects > 90% of children
- Vaccination age can be lowered to 6 months in epidemics.
- Measles shows a cyclic trend with epidemic every 2-3 years.
- Eradication of measles requires vaccine coverage >95%
Don’t Forget to Solve all the previous Year Question asked on Measles- Vaccination and WHO’s measles elimination strategy
Click Here to Start Quiz
Click Here to Start Quiz
