Nearly a month after the conclusion of a special nationwide immunisation campaign, measles has not yet been fully brought under control in Bangladesh, although infections and deaths have declined compared to the earlier phase of the outbreak, public health experts said.
Health experts warned that a significant number of children remain outside vaccination coverage in both urban and rural areas. A large proportion of children currently being admitted to hospitals with measles are also unvaccinated, highlighting persistent gaps in coverage that officials attribute largely to inadequate publicity and weak last-mile outreach during the campaign.
Many guardians said they were unaware of the timing and location of the vaccination drive. Some were unable to vaccinate their children due to illness or other constraints, while others said they did not know where vaccination services were being provided.
Public health specialists said most of the children currently hospitalised with measles had not previously received any dose of the vaccine. They stressed the need to urgently identify missed children and bring them under routine immunisation services, alongside strengthening surveillance and community-level response mechanisms.
Mukta, a guardian of a child admitted to the Dhaka North City Corporation Hospital, said she was unaware of the vaccination campaign. “If I had known earlier, I would have brought my child for vaccination. There was no proper announcement in our area,” she said, adding that the lack of information contributed to the deterioration of her child’s condition.
Abdul Malek, who brought his child from Narsingdi, said he learned about the campaign too late. By then, his child had already developed fever and could not be vaccinated. “The doctor said the condition could have been less severe if the vaccine had been given earlier,” he said.
Public health experts said that although the immunisation campaign has helped bring the situation under partial control, measles has not yet been fully contained.
They stressed that, alongside hospital-based treatment, stronger field-level surveillance, rapid case detection, and preventive measures must be reinforced to effectively control the outbreak.
Vaccine expert Dr Md Tajul Islam A Bari said, under normal circumstances, health workers conduct door-to-door surveys before a campaign to prepare a detailed list of eligible children. However, due to the emergency nature of the recent drive, vaccinations were administered based on estimated targets, which may have resulted in many children being left out.
He added that, in some cases, IgG antibody testing may be necessary to assess vaccine effectiveness. He also recommended that a follow-up immunisation programme be considered for those who have not developed sufficient immunity.
Public health expert Dr Mushtaq Hossain said that the number of rapid response teams needs to be increased to ensure timely containment of the outbreak. He said that once a new case is detected, prompt action must be taken to identify and control infections in surrounding areas.
He further noted that gaps in field-level data collection during this phase, along with inadequate isolation facilities in hospitals, have contributed to the easy spread of the infection.
Meanwhile, Deputy-Director attached to the Expanded Programme on Immunization (EPI), Sabbir Haider said that although official reports claim 102 percent coverage, in reality a number of children remain outside the vaccination net.
He noted that such statistical discrepancies may arise due to differences in age cut-offs and target population estimates.
He added that the EPI is currently investigating the issue and will provide further details after updating the relevant data. He also said that children missed during the campaign will be brought under vaccination coverage in subsequent phases.
Public health experts said that alongside government interventions, parental awareness is crucial in controlling measles.
They noted that timely vaccination and ensuring adequate nutrition for children would make measles control efforts more effective.