AGE-APPROPRIATE VACCINATION AGAINST MEASLES AND DPT-3 IN INDIA - CLOSING THE GAPS

Tuesday, 23rd of April 2013

[source]BMC Public Health[|source]

Full text description of  the relevance of adherence to national immunization schedule for measles. Results of this study show that premature measles vaccination is rampant in India and could account for high numbers of measles cases in the country due to sub-optimal sero-conversion.  Details available in a provisional manuscript at: http://www.biomedcentral.com/content/pdf/1471-2458-13-358.pdf

Abstract

Background: In 2010, India accounted for 65,500 (47%) of the 139,300 measles-related deaths that occurred globally. Data on the quality of age-appropriate measles vaccination in rural India is sparse. We explored the following issues: (i) What proportion of Indian children were appropriately vaccinated against measles at 9 months of age, and DPT-3 at 4 months? (ii) Which health facilities administered measles vaccine to children prior to 9 months of age and DPT-3 prior to 14 weeks?

Methods: We analyzed data from the 2008 Indian District Level Health Survey (DLHS-3) to determine the extent of age-appropriate measles and DPT-3 vaccinations. Among 192,969 households in the dataset, vaccination cards with detailed records were available for 18,670 children aged between 12 and 23 months.

Results: Among this cohort, 72.4% (13,511 infants) had received the first dose of measles vaccine. Only 30% of vaccinated infants received the measles vaccine at the recommended age of 9 months. Similarly, only 31% of infants in the cohort received DPT-3 vaccine at the recommended age of 14 weeks. About 82% of all prematurely vaccinated children were vaccinated at health sub-centres, ICDS and Pulse Polio centres.

Conclusions: Age-inappropriate vaccination impacts adversely on the effectiveness of India's measles immunisation program due to sub-optimal seroconversion, if premature, and increased vulnerability to vaccine preventable diseases, if delayed. Capacity building approaches to improve age-appropriate vaccination are discussed.