Nepal's Measles-Rubella Immunization Campaign from 25th Feb

It is projected that some 5.7 million children of all ages will be immunized against measles-rubella as part of a planned campaign for this vaccine’s administration that will begin on February 25. This health initiative is expected to go down to 75 districts all over the country and affect children only.

Before this, Jajarkot and Rukum West of the quake of November 3 with 6.4 magnitude have already been through a campaign completion success.

Under this drive, children between nine months and 15 years belonging to the high-risk areas comprising 24 districts are planned for measles-rubella immunization as per Dr. Abhiyan Gautam, who leads the Immunization Section of the Family Welfare Division of the Department of Health Services. Doctor Gautam further clarified that in addition to the 10 districts mentioned therefrom will also be vaccinated kids ranging from nine months to five years of age in 51 other districts.

The target of Nepal’s eradication program has been to eliminate the incidence of measles by 2019, yet it shifted the target year to 2023. The standard for measles elimination is the maintenance of a case rate below 5 cases for every one million populace per annum.

Nevertheless, at the dawn of 2023, the virus had surfaced in more than 14 districts nationwide. Last year witnessed at least one fatality and numerous infections among children due to measles.

Dr. Gautam noted that the high-risk areas encompass 19 Tarai region districts bordering India alongside three from Kathmandu Valley. Measles outbreaks were recorded in Gokarneshwar of Kathmandu in June last year and also during some periods in 2020 within certain localities of Lalitpur and Kathmandu.

According to Gautam’s statements, approximately 150,000 children aged six months to five years have been vaccinated in Jajarkot and West Rukum.

Previously, an additional vaccination campaign specifically targeting quake-affected and high-risk areas was recommended by the National Immunisation Advisory Committee – an expert panel – which suggested that such a drive should encompass vaccinations against diseases including measles, rubella, polio, cholera, pneumonia, and influenza.

The catastrophic earthquake that struck Jajarkot and West Rukum districts in Karnali Province on November 3 claimed at least 154 lives with hundreds wounded and thousands displaced. A subsequent cold wave resulted in over 30 deaths among those displaced by the quake.

“We have received all necessary vaccine doses for the campaign and are proceeding with final preparations,” remarked Gautam regarding the current state of affairs about campaign readiness.

Ministry of Health officials have announced that this immunization endeavor will be conducted through schools within the vulnerable 24 districts to conclude before the Secondary Education Examination (SEE) commences.

The vaccine stocks have been provided by GAVI – The Global Alliance for Vaccines and Immunisation. Further integration into this initiative includes administering additional vaccines—namely pentavalent, pneumococcal conjugate (PCV), and inactivated poliovirus (IPV)—to those children who previously missed their scheduled vaccinations under routine health programs.

The country undertakes a national measles-rubella campaign once every four years aiming to reach children who did not receive their vaccines as part of standard health schedules. Notably, each year sees thousands missing out on these vaccines with routine coverage rates lingering below ninety percent.

To qualify for eliminating a disease such as measles attention must be directed towards achieving over a ninety-five percent vaccination rate expressed Dr. Shyam Raj Upreti, an expert in child health said.

Measles and rubella are highly infectious viral diseases that depend on airborne particles from the nose, mouth, or throat of the diseased individuals. Initial conditions are usually evident after 10-12 days and include high fever, nasal discharge, red eyes, and small white spots on the mouth. It is not uncommon for a skin rash to begin in the face and then spread to the upper neck after several days.

Measles was a common disease in Nepal until recently, as the country’s annual reports have shown that from 1994 to 2004 every year about 90,000 cases of measles were reported on average. As a response, Nepal’s government implemented the national campaign of mass immunization against measles in the late 1980s.

Having in mind to completely stamp out measles by the year 2019, Nepal delayed this target until the year 2023 when the resurgence of the cases continued to persist. More recently, the Ministry of Health and Population has delayed the measles elimination goal to 2026.