Mother and Child Health – Immunization Program, BPBB, PMJSY, PMMSY, etc.

Measles outbreak: Need to accelerate Children Immunization program


From UPSC perspective, the following things are important :

Prelims level: Measles and other contagious diseases

Mains level: Measles outbreak, Immunization program and the concerns



  • A measles outbreak in Mumbai has raised concerns amongst the country’s public health authorities. The city has reported more than 200 cases in the past two months and at least 13 children have lost their lives.

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Measles: A memory shot

  • Measles is a highly contagious viral disease.
  • Measles is caused by a virus in the paramyxovirus family and it is normally passed through direct contact and through the air.
  • The virus infects the respiratory tract, then spreads throughout the body.
  • Measles is a human disease and is not known to occur in animals.


All you need to know about Measles

  • Signs and symptoms include:
  • The first sign of measles is usually a high fever, runny nose, a cough, red and watery eyes, and small white spots inside the cheeks can develop in the initial stage.
  • The most serious complications include blindness, encephalitis, severe diarrhoea and related dehydration, ear infections, or severe respiratory infections such as pneumonia.
  • Who is at risk?
  • Unvaccinated young children are at highest risk of measles and its complications, including death.
  • Unvaccinated pregnant women are also at risk.
  • Any non-immune person (who has not been vaccinated or was vaccinated but did not develop immunity) can become infected.
  • Transmission:
  • Measles is one of the world’s most contagious diseases.
  • It is spread by coughing and sneezing, close personal contact or direct contact with infected nasal or throat secretions.
  • Treatment:
  • No specific antiviral treatment exists for measles virus.
  • Severe complications from measles can be reduced through supportive care that ensures good nutrition, adequate fluid intake and treatment of dehydration with WHO-recommended oral rehydration solution.
  • All children diagnosed with measles should receive two doses of vitamin A supplements.
  • Prevention:
  • Routine measles vaccination for children, combined with mass immunization campaigns in countries with high case and death rates, are key public health strategies to reduce global measles deaths.
  • The measles vaccine is often incorporated with rubella and/or mumps vaccines.

Reasons sought behind the sudden outbreak of Measles in India

  • A backslide in the universal immunisation programme during the pandemic:
  • By all accounts, the outbreak seems to have been precipitated by a backslide in the universal immunisation programme during the pandemic.
  • According to the state government data, only 41 per cent of the eligible children have been inoculated against measles in Mumbai.
  • Vaccine hesitancy:
  • Parents, reportedly, are showing a disinclination to continue the inoculation regime for their children after they developed fever on being administered the first jab.
  • Overworked public health professionals, including ASHA workers, have also had to combat vaccine hesitancy.


Government efforts and the status of Immunization programs

  • Mission Indradhanush: In recent years, the Centre’s Mission Indradhanush project has improved vaccine coverage and reduced delays between shots.
  • Low coverage in last two years: WHO and UNICEF studies have shown that immunisation programmes especially those focusing on DPT (diphtheria, pertussis and tetanus) and measles have taken a hit in low- and mid-income countries, including India, in the past two years.
  • Missed shots during Pandemic restrictions: Early in the pandemic, the National Health Mission’s information system reported that at least 100,000 children missed their shots because of the restrictions on movement.
  • India speeding up the immunization after the pandemic: Anecdotal reports do indicate that India’s universal inoculation programme picked up during the latter part of the pandemic. But measles is a highly contagious disease. Experts had cautioned that even a 5 per cent fall in the vaccination rate can disrupt herd immunity and precipitate an outbreak. The surge of the disease in Mumbai indicates that their fears are coming true.

Countries with lower per capita incomes are more at risk

  • Measles is still common in many developing countries particularly in parts of Africa and Asia. The overwhelming majority (more than 95%) of measles deaths occur in countries with low per capita incomes and weak health infrastructures.
  • Measles outbreaks can be particularly deadly in countries experiencing or recovering from a natural disaster or conflict. Damage to health infrastructure and health services interrupts routine immunization, and overcrowding in residential camps greatly increases the risk of infection.
  • Measles outbreaks can result in epidemics that cause many deaths, especially among young, malnourished children. In countries where measles has been largely eliminated, cases imported from other countries remain an important source of infection.



  • Studies have shown that child vaccination had suffered during the pandemic as attention shifted towards adult vaccination. Now that the pandemic has waned, governments must carefully evaluate at the grassroots how many children fell out of the vaccine net during this period and take countermeasures.

Mains question

Q. Measles is a highly contagious disease with a high mortality rate in unvaccinated children. Discuss the reasons behind the recent outbreak of measles in India.

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