Measles-rubella (MR) vaccine
24-Jan-2023: India to eliminate Measles and Rubella (MR) by this year
India had set a target to eliminate Measles and Rubella (MR) by 2023, having missed the earlier deadline of 2020, due to a variety of reasons, exacerbated by disruptions due to the pandemic.
India
- Missed 2020 deadline for elimination
- Adopted the goal of elimination by 2023
- Conducted phased measles catch-up immunization for children aged 9 months–10 years in 14 States
- Launched Mission Indradhanush in 2014 to ramp up vaccinating the unvaccinated population
- Adopted a national strategic plan for measles and rubella elimination during 2017–2021
- Introduced rubella-containing vaccine (RCV) into the routine immunization program
Measles
- Highly contagious viral disease
- Single-stranded RNA virus
- Causes death among young children globally
- Particularly dangerous for malnourished children and those with reduced immunity
- Can cause serious complications, including blindness, encephalitis, severe diarrhea, ear infection, and pneumonia
Rubella
- Also called German Measles
- Contagious, generally mild viral infection
- Single-stranded RNA virus
- Causes Congenital Rubella Syndrome (CRS) which results in irreversible birth defects
- Not as infectious or as severe as measles
- Causes red rash
Global Scenario
Measles
- One of the world’s most contagious human viruses
- Kills more than 100,000 children every year globally
- Estimated to have averted more than 30 million deaths globally in the past two decades
Rubella
- Leading vaccine-preventable cause of birth defects
- Averted through rubella-containing vaccine (RCV)
Measures to Curb MR
Measles-Rubella Vaccination
- Targets around 41 crore children across the country
- All children aged between 9 months and less than 15 years are given a single shot of MR vaccination
- Provided in the form of measles-rubella (MR), measles-mumps-rubella (MMR) or measles-mumps-rubella-varicella (MMRV) combination
Other Initiatives
- Universal Immunization Programme (UIP)
- Mission Indradhanush
- Intensified Mission Indradhanush
Hybrid Immunity
20-Jan-2023: “Hybrid immunity” provides better protection against severe Covid-19: The Lancet Infectious Diseases
Hybrid Immunity is a combination of natural protection and vaccine-induced immunity.
Study: Meta-analysis of 11 studies on protection from previous SARS-CoV-2 infection and 15 studies on hybrid immunity
Highlights:
Better protection: Higher magnitude and durability than infection alone
Faster-spreading of omicron variants is leading to more infections and consequently more people developing this hybrid immunity.
Efficacy of Hybrid Immunity:
Protection against severe disease and hospitalizations:
- 82.5% at 3 months after last shot/infection
- 74.6% at 12 months
- 71.6% at 15 months
Protection against reinfection:
- 65.2% at 3 months
- 24.7% at 12 months
- 15.5% at 15 months
Hybrid immunity with primary vaccine doses:
- 96% at 3 months
- 97.4% at 12 months
- 69% protection against reinfection at 3 months
- 41.8% at 12 months
Hybrid immunity from infection + primary + booster dose:
- 97.2% at 3 months
- 95.3% at 6 months
Implications:
- Tailor guidance on number and timing of SARS-CoV-2 vaccinations
- Primary vaccination in regions with high sero-prevalence offers high protection against severe disease and hospitalisation for at least one year.
Gonorrhea
17-Jan-2023: Antimicrobial-resistant gonorrhea outbreak has hit Kenya
Gonorrhea
- A sexually transmitted infection caused by Neisseria gonorrhoeae
- Symptoms: Can be asymptomatic, can infect genitals, rectum, throat
- Risks: Infertility, increased risk of HIV infection
- Treatment: Antibiotics, but resistance is increasing
Antimicrobial Resistance (AMR)
- Ability of microorganisms to resist antimicrobial drugs
- Causes: Poor infection control, overuse of antibiotics, genetic mutations
- Impacts: Prolonged illness, disability, death, increased healthcare costs
- Recognition in India: National Health Policy 2017 & Ministry of Health & Family Welfare highlights the problem of antimicrobial resistance and calls for effective action to address it.
Government Initiatives
- National Programme on AMR containment (2012)
- National Action Plan on AMR (2017)
- AMR Surveillance and Research Network (2013)
- Antibiotic Stewardship Program (ICMR)
World Health Organization (WHO)
- Gonorrhea: Second-most common sexually transmitted disease
- AMR: Threatens healthcare systems, sustainability
Prevention
- Limiting use of antimicrobial drugs
- Improving infection control
- Investing in research and development
- Promoting international cooperation