KhasraRakshakAbhiyaan'

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-.~- --- - -.-----------, - KhasraRakshakAbhiyaan' TheGovernment of Indiahasdecidedtointroduceaseconddoseofmeasles vaccineintheroutineimmunization(ri)programme.

2 -.~ , - KhasraRakshakAbhiyaan' TheGovernment of Indiahasdecidedtointroduceaseconddoseofmeasles vaccineintheroutineimmunization(ri)programme. Thefollowing14states, withmeaslesvaccinecoveragebelow80%,willhavecatch-upcampaigns in differentphasesfor theseconddose:arunachalpradesh,assam,bihar, Chhattisgarh,Gujarat,Haryana,Jharkhand,MadhyaPradesh,Manipur, Meghalaya,Nagaland,Rajasthan,TripuraandUttarPradesh.Inthe remainingstatesandunionterritoriesa seconddoseof measleswillbe givenin theriprogrammeat 16-24monthsof age. There are two parts in this guide. Part 1 answers operational issues. Part 2 provides answers to some ofthe frequently asked questions on measles. PART 1 What is a measles catch-up campaign? A measles catch-up campaign is a special campaign to vaccinate all children in a wide age group with measles vaccine, in a state or a district. The catch-up campaign dose is given to all children, both previously vaccinated and un-vaccinated, who belong to the target age group. The goal of a catch-up campaign is to quickly make the population immune from measles and reduce deaths from measles. A catch-up campaign must immunize nearly 100% of the target age group children. Who should be vaccinated? o All children who have completed 9 months of age and are below 10 years of age (completed nine months since birth but have not reached 10th birthday). o A child in the target age group should always get the campaign dose of measles vaccine even if the child was vaccinated earlier. o A child with a history of having measles in the past should also be vaccinated if the child is in the target age group. o Malnourishedchildren shouldbe vaccinatedon priority since they have a higher risk of complications and death if they get measles. o Children with minor illnesses such as mild respiratory infection, diarrhoea, and low grade fever, should always be vaccinated.

KhasraRakshakAbhiyaan Where shall the children be vaccinated? Children will be vaccinated from fixed posts only. There will be no house-to-house vaccination.

3 KhasraRakshakAbhiyaan Where shall the children be vaccinated? Children will be vaccinated from fixed posts only. There will be no house-to-house vaccination. In the first week, students will be vaccinated in schools. Non-school-going and left out children will be vaccinated in the following two weeks in fixed outreach sessions in villages and urban areas. Who should NOT be vaccinated? Do not vaccinate if the child has: High fever or other serious disease (eg: unconscious, convulsions, etc).. Hospitalized children..history of a severe allergic reaction to measles vaccine in past. MEASLESVACCINATION- ROUTINEANDCAMPAIGN' A 10.monthold child has not receivedany measlesvaccinedosethrough routineimmunization.the child'sparentscometo get the childvaccinated againstmeaslesfor the first time duringthe campaign.the child is given measlesvaccinedose.howwouldthis dosebe recorded?andwhatadvice shouldananganwadiworker/ashagivetheparentsfor subsequentmeasles vaccinedoses?.this measles vaccine dose should be recorded as a campaign dose in the measles campaign card. Adviseparentsto bringthechildto gettheroutinedoseof measlesvaccine 4 weeksafterthecampaigndose.recordthisdoseinthe RIcard. A 2.yearoldchildhadgotonedoseof measlesvaccinethroughroutine immunizationwhenthe childwas9 monthsold. Hermotherwantsto knowif herchildshouldgetcampaigndoseof measlesvaccine. Yes,thischildshouldgetthecampaigndose. An 11.montholdchildhasgotonedoseof measlesvaccinethroughroutine immunizationoneweekbeforestart of campaign.shouldthe child get the campaigndosenow?.yes, thischildshouldbeimmunizedwiththecampaigndosetoo.thereis no addedriskof sideeffectsbecauseof theseconddose. Answersto FrequentlyAskedQuestionson Measlesfor healthworkers

"_-_ ---L - -_.._ ~ - ~-~.,T~~". Khasraf"Rakshak Abhiyaan - Role of Team Members Each member of the vaccination team has a specific role in the campaign as below: Vaccinator ASHA/AWW Volunteer.

4 "_-_ ---L - -_.._ ~ - ~-~.,T~~". Khasraf"Rakshak Abhiyaan - Role of Team Members Each member of the vaccination team has a specific role in the campaign as below: Vaccinator ASHA/AWW Volunteer. Prepare microplan of their. Participate in AWW/ASHA Crowd control area orientation at PHC.. Tally marking for Participate in training and. Prepare due list to vaccinated children inform/motivateaww/ distribute invitation cards. Remind parents of ASHAtoattendorientation to parents at least 3 days eligible children to. EnsureAWW/ASHA prepare prior to the campaign complete routine due list and distribute. Mobilize community and immunization invitation cards parents to bring target.. Finger-mark Inform/contactcommunity age group children for vaccinated child leaders/prifor help to make vaccination. Give completed campaign successful. Recordcampaign dose in vaccination card to. Maintain cold chain and tally sheet child administer safe injections. Ask each beneficiary to Disposeoff waste safely wait for halfanhourafter. Checkthat tally forms are vaccination correctly completed.. Identifycampaign-left-out Superviseand guide the children and help ANM to team (ASHA,AWW and immunize them on RI volunteers) days during and after. Wait for one hour after campaign vaccinating the last child at the site to respond to AEFI,if any. Ensure vaccination of campaign-left-out children on RI days during and after campaign Guidelines for listing targeted children and issuing invitation cards 1. ANM and ASHA will frame a timeline jointly for preparation of due-list and distribution of invitation cards. 2. ASHA should complete listing of targeted children at least one month before the campaign. 3. Medical Officer in charge ofphc will make alternate plans for villages/areas without ASHA. I =I AmweffitoF,,",eo',Asked0."00" 00M"'" 1mh Wo",""

5 -,,;;~~,,;' -. Khasra'Rakshak Abhiyaan 4. In consultationwith ANM, the ASHA should makeplans to deliver filled invitation cards with information about session site, date and time to every beneficiary in the week before the campaign (before the school week). 5. Develop a plan with ANM to organize village-level meetings for social mobilization. 6. Decide on the dates for the meeting in each village at least one month before the campaign so that ASHA or the anganwadi worker organizes the meeting and the ANM also participates. You're invited for. the Measles Catch~up Immunization Campaign ~ m'a1 _ GlSessaan: rotc ---,-- : - -- Guidelines for holding community meetings 1. Hold meetings at a convenient time and place after consulting community leaders. 2. Identify local community representatives who would participate in the meeting. 3. Provide a comfortable and welcoming environment for discussion. 4. Listen to the community. Find out what the community already knows about measles disease and immunization. 5. Provide information on the importance of routine immunization including measles vaccination and where and when services are available. 6. Dispel misinformation and doubts that surround vaccination. 7. Encourage community members to ask questions. 8. Convey key messages on measles and the campaign to participants. 9. Motivate caregivers of children face to face to participate in the campaign: i. During house visits for beneficiary listing and invitations. ii. During session days visiting the houses of missed children to mobilize them. iii. After the campaign visits to missed houses to call them for RI session. Answersto FrequentlyAskedQuestionson Measlesfor healthworkers

6 KhasraRakshakAbhiyaan PART 2 Frequentlyasked questions on measles What causes measles? Measles is caused by a virus. How does measles spread? Measles is spread through the air by infectious droplets and is highly contagious. The measles infection spreads very fast. When a person infected with measles sneezes or coughs, infected droplets spread in the air. Those who are exposed to these droplets get infected. What are the symptoms of measles? Symptoms include fever, runny nose, cough, loss of appetite, "redness in eye", and a rash. The rash usually lasts 5 to 6 days and begins at the hairline, moves to the face and upper neck, and proceeds down the body. How long does it take to show signs of measles after being exposed? It takes about 10 to 12 days from exposure to first symptom, which is usually fever. The measles rash appears approximately 2 to 3 days after the fever begins.

7 How serious is measles? Measles can be a serious disease, with 30 out of 100 reported cases experiencing one or more complications. Complications from measles are more common among very young children (younger than five years of age) and adults (older than 20 years of age). What are the possible complications from measles? Diarrhoea, ear infections, and pneumonia account for 60% of measles-related deaths. Approximately, one out J of one million cases will develop acute encephalitis, an inflammation of the brain. This serious complication can lead to permanent brain damage. Who gets severe measles? Measles can be especially severe in persons with low immunity. Measles is more severe in malnourished children, particularly those with deficiency of Vitamin A. Is there a treatment for measles? There is no specific treatment for measles. People with measles need bed rest, lots of fluids, and control of fever. Patient should receive two doses of Vitamin A on subsequent days immediately after diagnosis of measles disease. The dose is 50,000 IU for children under 6 month, 1 lac IV for children 6-11 month and 2 lac IV for children above 1 year. Vitamin A administration decreases the risks of complications and death. How long is a person with measles contagious? Measles is highly contagious and can be transmitted from four days before the rash becomes visible to four days after the rash disappears. How is measles vaccine given? Measles vaccine is a shot given subcutaneously in the right arm. What side effects have been reported with the measles vaccine? The vaccine may cause slight fever, or a mild rash in some children.when they occur, fever and rash appear 7 to 12 days after vaccination. Severe reactions are rare. Can the vaccine cause measles? Because the measles vaccine is "live," it can cause mild measles-like symptoms in some recipients, but it does not cause measles disease. Does one have to pay for the vaccine during a campaignor in RI? No. The measles vaccine is absolutely free during the campaign and under RI programme in all government health facilities. AnswerstoFrequentlyAskedQuestionsonMeaslesforhealthWorkers

Key facts about measles 1. Measles (khasra) kills nearly 100,000 children every year in India. 2. Measles is a highly infectious disease. It is caused by a virus.

8 Key facts about measles 1. Measles (khasra) kills nearly 100,000 children every year in India. 2. Measles is a highly infectious disease. It is caused by a virus. It spreads from person to person through coughing, sneezing, etc. 3. A person having measles shows symptoms of fever and rash, cough or runny nose or redness of eyes. 4. Measles can be prevented by a measles vaccine. Two doses provide adequate protection. The first dose should be given along with Vitamin-A syrup when the child has completed 9 months of age. 5. Usually un-immunized children get measles. 6. A measles case is infectious from 4 days before appearance of rash to 4 days after the rash has subsided. 7. Measles can cause complications such as diarrhoea, pneumonia, mouth ulcers, ear infection, damage to eyes, and brain infection. 8. Measles can lead to death from complications that it causes. 9. Death from measles can occur within 30 days after onset of rash. Rash may not be present at time of death. 10. Vaccination is the only method of preventing measles.

Measles Immunization Catch-up Campaign

Measles Immunization Catch-up Campaign What is measles? Measles is one of the most infectious diseases. Measles is an acute viral illness caused by a virus from the paramyxovirus family. Almost all children