The Ministry of Health And Family Welfare is yet to include the vaccine for German measles or rubella, which is responsible for a large number of congenital defects, in the Universal Immunisation Program (UIP), despite the National Advisory Body on Immunisation recommending its inclusion in 2014.
Officials say that since no all-India publicity campaign for the vaccine has been done yet, it was “not yet feasible” to include the medicine in the UIP. According to official sources, an estimated Rs 1,000 crore is needed to publicise the campaign for rubella vaccine all over India. Those pushing for early introduction pin their hopes on Prime Minister Narendra Modi, who on 3 July 2014, while announcing the addition of four new vaccines in the UIP, had included vaccines against rotavirus, polio (injectable), Japanese encephalitis and rubella. In his announcement, the PM had mentioned that around 2 lakh babies are born with congenital defects each year in the country. Rubella, according to Ministry of Health officials, is one of the main reasons behind these cases of congenital defects.
As per the latest data available with the Ministry of Health, the diseases that are covered under the UIP are diphtheria, rotavirus (in the four states of Orissa, Himachal Pradesh, Andhra Pradesh and Haryana), whooping cough, tetanus, polio, tuberculosis, measles, Hepatitis B, Japanese encephalitis (commonly known as brain fever), meningitis and pneumonia caused by Haemophilus Influenzae type B.
Replying to this newspaper’s queries on the status of including rubella vaccine in the UIP, the Ministry of Health confirmed that the vaccine was still not a part of the UIP: “Government of India is in the process of introducing the measles-rubella (MR) vaccine in the UIP and the same is expected soon. Before the introduction of any vaccine, background/preparatory activities are carried out, like strengthening of surveillance activities, preparation of operational guidelines, documentation and background material, assessment of vaccine availability etc. India has a large birth cohort, which translates to a large vaccine requirement, and given the limited manufacturers and supply of the vaccine, the background activities are being done to ensure smooth implementation.”
According to the reply, the ministry did not have any official data on the number of children born in the country with rubella. It needs to be added that the effect of mixing specific vaccines together for children is yet to be completely ascertained, and this may explain the delay in the introduction of the rubella vaccine.
The rubella virus infects pregnant women and leads to babies being born with cardiac, cerebral, ophthalmic and auditory defects. Health experts say that rubella primarily affects the foetus if the mother is infected in the first three months of pregnancy. Experts say that if a woman gets rubella in the early months of her pregnancy, there is a chance that her baby will be born deaf or blind, with a damaged heart or small brain, or as mentally challenged. Miscarriages are also seen among women who get rubella while they are pregnant. This infection also leads to foetal death, spontaneous abortion or premature delivery.
The greatest danger from rubella is to unborn babies. Many mothers, who contract rubella within the first critical trimester, either have a miscarriage or a stillborn.
Rubella is caused by the rubella virus (Toga virus), which spreads through the air by droplets from the infected person. The Indian Academy of Paediatrics, the premier body of paediatricians in the country, had “very strongly” recommended the inclusion of the vaccine for rubella in the UIP in 2014.
The recommendation to make a vaccine against rubella a part of the UIP was also made by the National Technical Advisory Group of India, the country’s apex scientific advisory body on immunisation, after numerous scientific studies and comprehensive deliberations.
Gujarat-based paediatrician Manorama Mehta, who was the superintendent of the Rajkot-based K.T. Children Government Hospital, said that the government has already included certain vaccines under the UIP in 2014 and 2015, without any publicity so it needed to act on the rubella vaccine.
“As per my experience, at least 150 congenital cataract operations are done every year in government hospitals in Rajkot and many more such operations are carried out in private hospitals. So, one can just imagine the number of children who are affected by this virus all over India. Ever since this vaccine was introduced in the western countries, incidence of congenital rubella syndrome has come down by 95%. The vaccine for rubella is already available in India and the government would be doing a great service by including the rubella vaccine in the UIP,” she said.