Top 5 Takeaways

1. Increased Vaccine Coverage: From 2005 to 2021, coverage with the first dose of a measles-containing vaccine (MCV) increased from 68% to 89%, and the second dose from 27% to 82%.
2. Decline in Disease Incidence: Measles and rubella incidence decreased by 62% and 48% respectively during 2017–2021.
3. Implementation of National Strategies: This includes the introduction of the rubella-containing vaccine (RCV) in 2017 and large-scale supplementary immunization activities (SIAs).
4. Challenges During COVID-19: The pandemic led to a decrease in routine vaccination coverage and challenges in surveillance sensitivity.
5. Future Goals: The “Roadmap to Measles and Rubella Elimination in India by 2023” aims to intensify efforts towards eliminating these diseases with a focus on district-level implementation.

Original Article Author and Citation

Corresponding Author

Ratnesh Murugan, muruganr@who.int, 91-981-831-6527.

Suggested Citation

Murugan R, VanderEnde K, Dhawan V, et al. Progress Toward Measles and Rubella Elimination — India, 2005–2021. MMWR Morb Mortal Wkly Rep 2022;71:1569–1575. DOI: http://dx.doi.org/10.15585/mmwr.mm7150a1.

Summary

India has made significant strides toward eliminating measles and rubella. Vaccine coverage for measles and rubella has substantially increased, leading to a marked decrease in the incidence of these diseases. The introduction of the rubella vaccine in 2017 and the execution of extensive immunization campaigns have been pivotal in this progress. However, the COVID-19 pandemic posed challenges, causing a decline in vaccination coverage and surveillance sensitivity.

Methods

The approach included routine and supplementary immunization strategies, the implementation of RCV in the immunization program, nationwide measles-rubella SIAs, and a shift to case-based acute fever and rash surveillance. Additionally, the number of laboratories in the measles-rubella network was increased to enhance diagnostic capabilities.

Discussion

Despite remarkable progress, India faces ongoing challenges in eradicating these diseases by 2023. The pandemic has impacted vaccination coverage and surveillance. In response, India has disseminated updated guidance for continuing immunization and surveillance and is transitioning to a real-time integrated disease surveillance system.

Conclusion

India’s efforts towards measles and rubella elimination demonstrate a significant public health achievement. The roadmap adopted for 2023 focuses on intensifying actions at the district level, tracking progress, and program review. This is crucial for a country with a large annual birth cohort, representing a vital opportunity to prevent morbidity and mortality from these diseases.The progress achieved and challenges faced underscore the need for continued and intensified efforts to reach the elimination goals.

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