Vaccination
Does your child need the MR vaccine? Experts explain.
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(Update: Kerala will start the Measles-Rubella (MR) vaccination campaign from October as part of the National Immunisation Programme. Media reports state that the Health Department has a tough job in its hands. Not only will they have to convince the public about why the vaccine is necessary, but it will also have to counter negative propaganda against the campaign those who are anti-vaccination, as C. Maya points out in a report for The Hindu. Here's a TNM story from earlier this year which has experts addressing concerns surrounding the vaccine drive.)

The MR vaccine, being made mandatory for children between 9 months and 15 years, will be administered to an estimated 41 crore children in the country. The drive will be introduced in several phases in the country starting with Phase 1 which includes Tamil Nadu, Karnataka, Puducherry, Goa and Lakshadweep.

An online petition was started by a Bengaluru-parent raising several questions over the need for the vaccine. Seeking data backing the immunisation drive, Saransh Kal, the petitioner, asks, "Is there any way we can discuss this with a government body? Can a health official take a personal undertaking that this vaccine is important and more importantly harmless?"

Ample number of messages claiming that the vaccine has been banned in the US but is being launched in India and that pharmaceutical companies are just looking to push these products in the country, are also doing the rounds. 

Is the vaccine really required?

Dr Fulton D'Souza, Professor of Pediatrics, St John's Hospital, Bengaluru, explains that polio, measles and rubella are the only three diseases transmitted by humans and only found in humans. "So, if the disease is controlled in humans, it can easily be eradicated," he says.

"We started with the Pulse Polio programme and have successfully eradicated poliomyelitis. Now we are entering the next phase and focusing on rubella, and measles, which is a deadlier disease. In American and European countries, the diseases have already been eradicated and we too have to work towards achieving the same in our country," he added. 

Responding to claims of the vaccine being unsafe, Dr Fulton advices people to "only seek the information from medical practitioners in such cases and no one else". 

According to Dr T Jacob John, former Professor and Head of Department of Clinical Virology, the drive is a "very good project", one that should have come a decade ago. 

But, he admits that concerns surrounding the vaccination are also "legitimate". 

"Unlike in the case of polio eradication, where public awareness had been created which in turn prepared people for it, in the case of the MR vaccine there's hardly been any public announcements," Dr Jacob says. "People don't know that measles has been selected for eradication by 2010. Also, there's no intermediary between the government and public."

One big opposition against the drive is that the vaccination is administered using an injection and not as drops like polio vaccine.

"Injection safety is ensured by using auto disable syringes. They can be used only once and thereafter automatically disabled. UIP immunisation is the safest injection avoiding any possible reuse," says Dr Jacob.

One of the points made by Saransh Kal in his petition is that "MR vaccine for Measles & Rubella is already part of the immunisation schedule and given twice. Most pediatric doctors are finding the 3rd dose unnecessary". 

Dr Jacob goes on to explain that under the Universal Immunization Programme (UIP) of the government, a measles vaccination is administered to children when they are 9 months, in government hospitals. In private hospitals or private practice, along with the same vaccine, a Measles, Mumps, and Rubella (MMR) vaccine is also given to children at 15 months. 

So, those children who received vaccinations at private hospitals have already got one dose of rubella and two doses of measles vaccine, which is highly effective if given at the right age.

"But the private sector reaches only 25% of the population, and in order to eradicate measles and rubella, both contagious diseases, 100% of the children need to be vaccinated," he says. "You can't blame the government because this is a practical solution."

So is an additional dose harmful?

"Additional doses over and above two Ms and one R, are absolutely harmless -- I can guarantee. Unnecessary, but harmless. The contents are attenuated (non-virulent) viruses and if a child is already immune, the body simply ignores the next encounter," says Dr Jacob.

But can't the children who have already received the vaccine be excluded from the drive? 

Stating that such children are likely to belong to a smaller category, Dr Jacob says that the other problem here is that there are no proper records on vaccination. 

"The original sin of the government is to make UIP just a vaccine delivery machine. It has no mandate to find out who received the vaccines, how many times did they get it and which vaccines were administered to them. Such information should ideally be on the fingertips of district health departments. When the government can go digital for monetary transactions, why shouldn't public health data also be made digital?" he asks. 

Dr Jacob also clarifies that the pharmaceutical company manufacturing the MR-VAC, is an Indian one and not foreign. "So, no money is going out of India. And no foreign company is making profits," he says. 

Read our earlier stories: K’taka govt plans largest vaccination drive, but confusion prevails among schools, parents

Concerns over MR vaccine among parents, Health Minister says fears unfounded