Southern States - Tamil Nadu   

TN to include MMR, rubella in immunsation schedule

By Ramya Kannan

Chennai Feb. 8. In a significant deviation from the National Immunisation Schedule, Tamil Nadu is all set to launch a pilot project in five districts to administer the measles, mumps and rubella (MMR) vaccine to children and the rubella vaccine to adolescent girls.

In what is envisaged as a bold step, Tamil Nadu, which has been petitioning the Centre to include MMR in its immunisation schedule for years, has decided to go ahead with this pilot project.

The new immunisation schedule will be launched in one block each in Theni, Vellore, Tiruvannamalai, Cuddalore and Perambalur districts.

An estimated of 25,000 children in the age group 24-60 months and as many adolescent girls between 10 and 15 years will benefit from the project, the total cost of which is pegged at Rs. 6.62 crores. The pilot project alone is likely to cost around Rs. 25 lakhs.

Conceptualised under the World Bank-assisted ICDS project and executed by the Public Health department, the vaccine (0.05 ml) will be administered through subcutaneous injection at anganwadi centres and schools, according to ICDS officials. As has been done for the Pulse Polio campaign, certain days will be designated `immunisation days' and hectic IEC communication activities will precede the IDs, says the Social Welfare Secretary C.K. Gariyali.

After adequate `social marketing' for days, all children in the relevant age group will be given the MMR, while adolescent girls will receive the shots in schools. "As per the National Immunisation Schedule, only measles vaccination is given by the Government. However, mumps causes infertility and rubella is a known cause of blindness, mental retardation, deafness and heart problems in children. Therefore integrating MMR into the regular schedule is of immense public health significance," according to the Director of Public Health, P. Krishnamuthy.

German measles dangerous

Though actual government statistics correlating the influence of rubella/German measles on disabilities are not available, public health experts say they have reason to believe that nearly 50 per cent of the disabilities in children in the State are a result of the mothers having suffered from rubella. Though it manifests as a slight rash and fever in the adult, German measles will prove dangerous to the child if the mother is infected during the first trimester.

The rubella syndrome is identified when the baby has ``congenital cataract, heart disease and hearing defects and microcephaly (in some cases, mental retardation)'', say paediatricians.

"In terms of preventing handicaps and ensuring that children do not contract measles and mumps, MMR is the best solution. Providing the rubella vaccine to adolescent girls is advisable as they are future mothers," according to P. Rama Devi, director and superintendent (in charge), Institute of Child Health.

The government decision also brings cheer to those working in the area of disability detection and rehabilitation.

At the Madhuram Narayanan Centre for Exceptional Children in the city, volunteers identified at least six cases of children afflicted with rubella between September and November last.

In this context, activists believe that the immunisation will go a long way in reducing the number of disabilities.

The cold chain facilities in the State will be utilised to store the vaccine.

The modalities of procuring and storing it are being discussed. Each MMR vial is expected to cost around Rs 70, while the rubella vaccine alone will cost Rs. 30.

Three rounds of vaccination will be required before every member of the target group is immunised, say the ICDS officials.

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