The government will launch an intensified measles-rubella catch-up vaccination program on September 26 to vaccinate around 3.4 million children aged 6 months to under 5 years who were missed during the campaign. The program will continue until October 31.
Health and Family Welfare Minister Sardar Md. Sakhawat Husain announced the program at a press conference at the Secretariat on Sunday.
The health minister said: “The 3.4 million children who did not receive or were missed during the ongoing measles-rubella campaign will be identified through door-to-door visits and vaccinated. At the same time, newly eligible children who reach 6 months of age during this period will also be brought under the program.”
He said the government had taken a series of measures to control infections and protect children after a measles outbreak emerged in the country this year. Around 19.83 million children have received vaccines through the measles-rubella vaccination campaign conducted in phases since April.
Alongside the vaccination program, efforts have been made to strengthen the routine Expanded Programme on Immunization (EPI), increase disease surveillance and ensure necessary treatment for children affected by measles, he said.
The government has also formulated a national guideline on “Measles-Rubella Clinical Case Management” and trained health workers on the issue, the minister said.
However, recent field-level data, Rapid Convenience Monitoring conducted by the World Health Organization (WHO) and United Nations Children’s Fund (UNICEF), and analysis of information on children affected by measles have shown that a significant number of children remain outside the vaccination program.
The health minister said many children identified with measles at various hospitals had not previously received measles vaccines. Therefore, the main objective of the special program is to quickly identify children who were missed and bring them under protection.
He said the program would not rely solely on the target or achievement figures of the previous measles-rubella campaign. The target for the national Vitamin A Plus Campaign involving children in the same age group was higher than that of the measles-rubella program, indicating that some children may have remained outside the existing lists.
Therefore, target and achievement data from the Vitamin A campaign, measles-rubella vaccination registers, local microplans, data from the previous campaign and field-level monitoring results will be combined to identify children who were missed, he said.
As part of the special program, health workers and volunteers will visit households to verify children’s vaccination status. Unvaccinated children will be listed and arrangements will be made to vaccinate them immediately.
The EPI has already begun preparations at the field level to implement the program. On September 13, the EPI wing of the Directorate General of Health Services (DGHS) instructed all field offices to submit the number of unvaccinated children aged 6 to 59 months within 3 days.
Letters were sent to the divisional directors of DGHS, civil surgeons, chief health officers of all city corporations, upazila health and family planning officers, and medical officers of municipalities.
The letters instructed them to send updated information on unvaccinated children aged 6 to 59 months in their respective areas by 2pm on September 16, “without fail”.
EPI Deputy Director Mohammad Sabbir Haider told Dhaka Tribune: “A letter was sent by EPI to identify unvaccinated children and submit the lists. Most districts and upazilas have already sent their lists, but some districts and upazilas are yet to submit them.”
Meanwhile, measles infections and deaths continue to rise. According to DGHS data, 4 more children died with measles symptoms in the 24 hours until 8am on Sunday, taking the total number of deaths to 1,057.
During the same period, another 1,136 children were infected with measles or developed measles symptoms, taking the total number of infections to 237,600, according to DGHS.
Public health experts said the situation was not fully under control because of gaps in vaccination coverage and inadequate public health measures, particularly to prevent infections among children under 6 months.
To control measles, the government launched an emergency measles-rubella vaccination drive on April 5. Within the scheduled period ending on May 20, 18.4 million children aged 6 to 59 months received vaccines, exceeding the target of 18 million.
Although infections, hospital admissions and deaths declined in June and July, experts said the decrease was not at the expected level.
Later, 22.3 million children in the same age group received services under the national Vitamin A Plus Campaign, which was 3.883 million more than the number targeted under the measles-rubella vaccination drive.
The government acknowledged that its target had been set too low, after which a “mop-up” campaign was conducted towards the end of July.
The initiative was still not sufficient, as the number of measles infections, hospital admissions and deaths began to rise again in August.
Against this backdrop, the latest meeting of the inter-agency coordination committee, chaired by Health Secretary Kamruzzaman Chowdhury on August 16, decided to conduct a 2- to 3-week catch-up vaccination program in high-risk areas.
The relevant authorities were also instructed to contact UNICEF to avoid a possible vaccine shortage.
Public health and vaccination expert Tajul Islam A Bari said children outside the 6- to 59-month age group were also being infected with measles. He said their inclusion in the vaccination program should therefore be considered.
He said: “It would be better if children up to 10 years of age could be included. At the same time, emphasis should be placed on raising awareness so that parents bring their children for vaccination.”
Professor Mahmudur Rahman, chairman of the National Measles and Rubella Elimination Verification Committee, said the special program could play an important role in controlling measles if unvaccinated children were properly identified and brought under vaccination.
However, he said vaccination alone would not be enough as children outside the specified age group were also being infected with measles. Raising public awareness on a large scale would also be necessary.
He added that awareness should be increased among everyone, including parents, about what to do if a child develops a fever and how to keep the child as separate as possible from others to reduce the risk of infection.
In response to a question from journalists at the press conference about whether children over 6 years of age would be vaccinated against measles, the health minister said they would not be included in the current catch-up program despite also being affected by measles.
The program will be conducted only for children aged 6 to 59 months.