Status of coverage of MR vaccination, after supplementary immunization activities in a rural area of South India: a rapid immunization coverage survey

Introduction: After a commendable achievement on Polio free status for South East Asian Region (SEAR), WHO (World Health Organization) is now focusing towards Measles elimination, which is still a major contributor of under-five mortality in South East Asian Region. India has introduced MR vaccination (Measles and Rubella) throughout the country through SIA (Supplementary Immunization Activity), followed by introducing the same in the routine immunization. Health indicators and Public Health System functioning in the Southern States of India are good So India had introduced MR campaign in the southern high performing states as phase I on 5th April 2017. The aim of this campaign was to cover more than 95% of the eligible children (9 months to 15years old). At the same time rumors and negative campaign about this initiative started in social media. This study aims to measure the coverage of MR vaccination among the target population in South India.

Methods: Data were collected immediately after the Phase I of MR vaccine campaign in April 2017. Data was collected base on the WHO recommended  30/7 rapid monitoring method. Thirty villages around the rural health training centre were selected and seven children from 9 months to 5 years and seven children from 6 to 15 years from each village were included. Children were classified in to “vaccinated” or “not vaccinated” based WHO ‘HISTORY OR CARD’ method.

Results: Among the total sample of 420 children, 380 children (90.5% (87.4-93.0)) were found to be vaccinated and 40 children (9.5% (7.0-12.6)) were found to be unvaccinated. Most of the people came to know about the MR vaccination through ANM (Auxiliary Nurses Midwives) followed by school teachers (table1). The main reason for not getting vaccinated was fear of AEFI (adverse event following immunization) or Fear of injection (table2). Reasons for not getting vaccinated were significantly associated with usage of Smartphone by at least one of the parents (adjusted OR 2.1 (1.1-4.2)), better literary level among mothers (Adjusted OR 5.2 (1.1-24.8)) and poor literary level among fathers (adjusted OR 3.6 (1.1-11.5)).

Discussion: Despite the negative propaganda by social media, the coverage of vaccination by the public health care providers was near optimal in  phase I, which shows the strength of public health system in  remote rural area of South India. In accordance with the modern technology, public health policymakers should think and plan the IEC (Information Education and Communication) activities.