Home            Past Issues            About IP            About IAP           Author Information            Subscription            Advertisement              Search  

   
correspondence

Indian Pediatr 2011;48: 245-246

First Dose of Measles Vaccine after 12 Months of Age


Sushil Mathew John and Kirubah Vasandhi David

Low Cost Effective Care Unit / Ida Scudder Urban Health Centre Christian Medical College, Vellore.
Email:
[email protected] 
 

When measles vaccine was included in our national Universal Immunization Program in 1985, the schedule was to give one dose between 9 and 12 months of age. With the emphasis on immunization coverage assessment at the end of the first year of life, 9-12 months was interpreted by health workers as the exclusive age window for the vaccine and children who missed it within that window were not given it at a later age. This was recognized and corrected by the National Technical Advisory Group on Immunization (NTAGI), resulting in a Government Order to ensure that a dose of measles vaccine should be given to all children up to age 5 (personal communication, John TJ, co-chair, NTAGI). Despite these guidelines, many health workers still believe that by 12 months the window for the vaccine is over. We illustrate this with a case report to highlight the need for wider publicity to ensure that the vaccine is not denied to any child on the basis of age.

An 18 month old child, not vaccinated against measles was hospitalized with severe measles in February 2010. The child was treated appropriately and recovered. Measles IgM antibody was detected according to standard methodology, confirming the clinical diagnosis. Colleagues in the Department of Child Health corroborated the occurrence of an outbreak of measles in at least one periurban village during January/February. The child’s mother reported that she had taken the child on completion of 9 months for the measles vaccine on 3 occasions, to the closest urban health center. Twice the health worker declined to vaccinate as the child had a mild cough and cold and the third time the mother was told that the child was too old to receive the measles vaccine, having passed the first birthday. The child had received all the other UIP vaccines including 3 doses of Hepatitis B vaccine, currently included in UIP in Tamil Nadu.

The refusal to offer measles vaccine after 12 months of age is a matter of serious concern. The Immunization Handbook for Medical Officers states that while the ideal target age to administer measles vaccine is 9 to 12 months, it is to be administered up to 5 years of age under the UIP [1]. We spoke with 2 staff members of 2 urban health posts; one said that measles vaccine should be given beyond 12 months up to 5 years but the second said she would not give the vaccine beyond 12 months of age. We reiterate the importance of informing all staff of the current guidelines to use every opportunity to vaccinate all children aged 10 months to 5 years against measles.

References

1. Immunization Handbook for Medical Officers. Ministry of Health and Family Welfare. New Delhi: Govt. of India; 2008. p 19.
 

 

Copyright© 1999 by the Indian Pediatrics (Disclaimer)