RATIONALE FOR MR VACCINE INTRODUCTION · parents about PTM /interaction ( SMS, Whatsapp, e mails, Student diary message, school website Provide links to key information Promotion

RATIONALE FOR MR VACCINE

INTRODUCTION

Training Workshop for Measles-Rubella Vaccination Campaigns 1

Presented by:-

Dr Ranjana Kakkar

District Immunization Officer

West District

Rationale for MR Vaccination Campaign

• Widespread Measles & Rubella outbreaks in

country

• Inadequate population immunity to interrupt

transmission of Measles and Rubella

• Pockets of low Measles vaccination coverage

• Select states, urban municipalities and Indian Army

already providing Rubella vaccine

• IAP Immunization schedule includes Rubella

containing vaccine

What are measles/rubella

diseases?

Measles is a highly infectious disease causing

illness and death due to complications in the

form of diarrhea, pneumonia .

Rubella is a mild yet highly contagious disease

that can cause crippling birth defects or the

death of the unborn child of an infected

pregnant woman.

Measles disease

• An acute viral infection spread via

respiratory secretions or aerosols

• Classic manifestations:

– Maculopapular rash

– Fever +cough + coryza/conjuctivities

• Complications and mortality highest in

children < 2 yrs. and in adults

• Case Fatality Ratio (CFR):

– Ranges from (0.1 – 10) %

– Up to 30% in humanitarian

emergencies (A Measles case from Nagaland, District Mon

4

What is congenital rubella syndrome

(CRS)?

• CRS is a set of serious congenital defects a

child may be born with when a pregnant

women gets rubella infection in her early

pregnancy (usually in the first trimester),

causing blindness, deafness, heart defects,

mental retardation, liver disorders etc.

Measles mortality: due to complications

Corneal scarring

causing blindness

Vitamin A deficiency

Encephalitis

Older children, adults

≈ 0.1% of cases

Chronic disability

Pneumonia &

diarrhea

Diarrhea common in developing countries

Pneumonia ~ 5-10% of cases, usually bacterial

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• Measles is one of the leading cause of death among young children despite

availability of safe and cost-effective vaccine

• 2016 : 90,000 measles deaths globally – Nearly 247 deaths every day or 10

deaths every hour

• Measles vaccination has resulted in 84% drop in global measles deaths between

2000 and 2016 (preventing 2.04 crore deaths).

- This makes measles vaccine as one of the best buys in public health

• In 2000 Measles 1st dose coverage through routine immunization was 73% ,

which has increased to 85% in 2016

Facts on Measles

NTAGI Recommendations-2014

• India along with other WHO SEAR countries in Sept 2013 resolved

to eliminate Measles and Control Rubella / CRS by 2020.

• WHO South East Asia Regional Strategic Plan 2014-20: Elimination of

Measles and control Rubella / Congenital Rubella Syndrome(CRS) by

2020.

• Accordingly, National Technical Advisory Group on Immunization (NTAGI)

recommended wide age range phased MR vaccination campaigns in all

states targeting children 9 months to < 15 years.

• All states introduce MR vaccine in it’s UIP schedule immediately after the

MR campaigns substituting both doses of measles vaccine with measles -

rubella vaccine.

MR Campaign

• MR Vaccine is being introduced through a campaign in a phased manner across the country without sub phasing within the states.

• Primary purpose of MR campaign is to attain high levels of population immunity by reaching wide age group,including children missed under EI program.

• High quality campaigns with at least 95% coverage.

• Early planning and preparedness is the key to quality MR campaign.

Planning the campaign

• Target age group: 9 months to <15 years

(regardless of prior immunization status or disease)

• Target to reach 100% eligible children

• Evaluated coverage more than 95 %

• Session site based approach – No House to

House vaccination.

NTAGI Recommends

Wide age range MR vaccination campaign

• targeting children from 9 months to 15

years

• high coverage (to knock down MR

transmission completely / to low levels)

• before introduction of Rubella Containing

Vaccine (RCV) in routine immunization

More than 13.43 crore* (134

million) children vaccinated safely in

28 states/UTs.

More than 40 crore (400 million) children to be vaccinated

during the MR Campaign

Completed - 21

Ongoing - 7

Planned - 8

RAJASTHAN

ODISHA

GUJARAT

MAHARASHTRA

MADHYA PRADESH

BIHAR

KARNATAKA

UTTAR PRADESH

JAMMU & KASHMIR

ASSAM

TAMIL NADU

TELANGANA

CHHATTISGARH

ANDHRA

PRADESH

PUNJAB

JHARKHAND

WEST BENGAL

ARUNACHAL PR.HARYANA

KERALA

UTTARAKHAND

HIMACHAL

PRADESH

MANIPUR

MIZORAM

MEGHALAYA

NAGALAND

TRIPURA

SIKKIM

GOA

A&N ISLANDS

D&N HAVELI

PONDICHERRY

LAKSHADWEEP

*As of 17th Nov 2018

~ 55 Lakh (5.5 million) (9 months to 15 years)

Campaign starts from January 2019

Target for Delhi

MR Vaccine Campaign: Implementation Strategy

14

Schools Community Last week

sweeping in low performing areas

4-5 weeks activity 1 week sweeping

School site vaccinations

Fixed in-facility sites Hospitals, PHCs, Dispensary, SC

Outreach session sites Villages, settlement,

colonies

Mobile sessions For far flung areas

Implementation of Session Sites

Key for Successful Campaign

• Strong political commitment and ownership

• Crucial role for Education department – 85 % beneficiaries are in schools

• Timely Microplanning and training

• Creating MR visibility and awareness at all levels – Print and electronic media are important- reached

proactively.

• Best way to reach parents through teachers – Whats app, Facebook, parents teachers meeting/ messages

etc.

• Private pediatricians and leading practitioners are opinion makers for vaccination

• Clear financial guidelines from state to district and below

Planning for school based MR Campaign

Education Department

Involvement


Communication from Ministry of HRD Secretary Education (states/UTs)

18

Strong engagement of schools (Public, Private and Catholic)

Concerns of school

Vaccine safety & need for additional doses?

Is it a government program only?

What is the take of international agencies?

Quality of vaccine?

Let us say hello to

Measles and Rubella vaccine

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Share stand of

WHO, Unicef, CDC, IAP, IMA, others

• One new syringe for every child

• Health department across India is

using AD syringes in immunization

programme since 2005.

• Mechanism of AD syringe is such

that it can not used again for the

second time.

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Let us say hello to

Auto disabled (AD Syringe)

In phase I and ongoing phase II -2017 (12 states/UTs)

More than 6 crore children vaccinated successfully

Role of Education Department

1. Share details & support planning

2. Training school and class lead

3. Awareness amongst parents

4. Engage students

5. Help on the day of vaccination

6. Support reporting & tracking of missed

children


Format 1 – School Pre Campaign

• This format has been distributed by

respective DEOs/MOIC to all schools.

• Each school has to submit completed

Format 1 separately to Health Facility either

in Hard copy/Soft Copy by 24th Nov 2018.

• Format 1 – School Pre Campaign will be

submitted to Health department (Medical

Officer of Dispensary/Health Facilities.

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M.O to check information gathered by education department & by health workers to consolidate list of

schools for microplanning

Format 2-A– School Pre Campaign (School Principal to ensure this information reaches MO I/C in time)

Block Village / Urban Area:

School name & address:

School vehicle available yes / no

Govt/ Private Co-ed/ Boys only / Girls only (Encircle)

School team leaders Principal name Landline Cell Board ICSE/CBSE/State/Others

School nodal person MR Campaign vaccination (Name & Tel number):

Total Students under 15 year : Total classes with children under 15 Total rooms in school

Class leads training planned on DD/MM/YYYY

Class leaders with Students details (up to 15 years ) Class/

class

section

Total

students

Name &

Mobile number of class lead (teacher)

PTM

date

planned

for MR

PTM

date

planned

for MR

Student –teacher interaction date planned

dd/mm/yy

yy

dd/mm/yy

yy 1st interaction

2nd interaction

dd/mm/yy

yy

dd/mm/yy

yy 1st interaction 2nd interaction

dd/mm/yy

yy

dd/mm/yy


dd/mm/yy

yy

dd/mm/yy


dd/mm/yy

yy

dd/mm/yy


Signature

Principal

Nursery 20 Ms Sonia 99XX55XX34XX

KG (A) 30 Ms Seema 95XX37XX39XX

KG (B) 25 Mr Pradeep 81XX24XX56XX39

Class1 (A) 30 Ms Roohi 95XX34XX89XX50

Signature

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4. Engage students



children


• School team leaders : 2 per school

– School Principal + one additional nodal officer for campaign from every school

(Govt, Private, Aided, Madrasas , pre nursery schools, Kindergarten, others

including schools for special, orphanages, others)

– Will be trained by Health Department/ WHO will monitor the training

• Class leader – class/ section teacher : 1 per class / per section

– Will be trained by School team leaders

• Class MR Warriors and Class wise Captains for MR Campaigns

(students) : 3-5 per class / section.

– Support teachers in MR activities

– Motivate cheer friends on vaccination day.

– Be part of team to hoist the “ We just did it …Measles Freedom flag”

– Will be trained by Class leader – class/ section teacher

Key Officials Education department in MR Campaign

27

The process…

Greet child Before going in the

vaccination room Class lead

(teacher) cross ticks the name in the

attendance register give child a

vaccination card , fill details except

date of vaccination child goes to

vaccination team

Class to Registration desk (location:

Inside or outside the vaccination room)

From vaccination room Direct child to join friends in observation

room / area observe for 30 min children may leave

From Vaccination Site to observation room/ area

Vaccinators greet child Take the card

given to child at registration desk

child is asked to sit Vaccinate child

Congratulate the child for defeating

Measles and Rubella Mark the left

thumb finger with indelible marker pen

Fill date of vaccination

From Registration desk

vaccination room

28

Role of Class Teacher/ MR warrior

On Day Of Vaccination

• Identifying a suitable room/place for registration of kids

• Identify a room where children can be comfortably

vaccinated

• If possible mark an area and depute people for

observing children after vaccination ( keep under

observation for 30 minutes)

• Arranging for logistics like curtains, drinking water etc.

• Make Missed out children list same day evening

(format 9 B)

• Contribute in painting display in vaccination room

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• Do include the doctors on

call / visiting doctors/

medical room staff in

school to attend the

training program

• Ensure that they are part

of the trainings with their

school leaders.

Doctors/ medical staff attached to schools

30





4. Engage students



children


Communication to parents

• Use available communication channel to inform

parents about PTM /interaction ( SMS, Whatsapp,

e mails, Student diary message, school website

• Provide links to key information

• Promotion message stickers with school names

• Play school children: Parents must be asked to

come to school on the given day/date

• For bigger classes the options are left to school.

• All children will have to wait for half an hour after

vaccination

32

33

What Parents need to know in PTMs (refer training material)

More than 6 crore children vaccinated in 5 southern states India heading for elimination of

measles

MR Vaccination – one shot campaign, Why the need, how will it help their child,

Additional dose irrespective of previous doses received or not

What is Measles and Rubella – the threat , disease, complications and how it will protect their children

MR Vaccine is WHO prequalified, one syringe one child, Vaccination will be provided

under medical supervision

Children should have had something to eat in morning. Severely ill children will not be vaccinated

Process of vaccination in schools from class to vaccination room, teacher escort, from vaccination room to observation room for 30 min)

34

Focused attention on Parent-Teacher meeting at

schools

MR campaign - Interaction of health department with

students, especially large private schools

School to parents messages

Rubber stamps design

Every child is special , every parent is a winner !!

Let us beat Measles and Rubella with MR Vaccination

One dose MR Vaccination campaign scheduled on ___________ day _________at_______am

Let us make our school proud by achieving more than 95% coverage and hoisting the flag - ‘WE JUST DID IT’

An effort towards making a healthier and disease free India

Holy Angels Holy Mother School, Hyderabad

37

Car/ Bike sticker -a few samples

War against Measles and Rubella Disease

My child will win, We will Win

Holy Angelian Mother


My child is a MR Vaccine Captain

Holy Angelian mother

38


My child is a MR Warrior

Holy Angelian mother





4. Engage students



children


Improving children participation: Drawings, painting

competitions

Improving children participation: Drawings, painting

competitions

Schools innovations team for MR Campaign

• 5 best activities in district : Following MR Campaign – best recorded activities to be judged by panel –WHO/UNICEF/ DIO/Lions club Other Partners and recommended for district awards – DM to award the winners

• Best district activities for state level award ( not more than 5 per district). Panel: WHO/UNICEF/Health deptt/Lions club partners will judge and recommend best 25 activities received from district for state level award. Principal Secretary, HM may do the honors .

42

Class teacher, Art teacher, Music teacher , SUPW teacher, IT Teacher

to support innovative activities

• 5 best activities of school for MR advocacy may be recorded and

sent by whats app/ others to …………………….





4. Engage students



children


44

Role of Class Teacher/ MR warrior On Day Of Vaccination

• Ensuring children are informed to not come empty stomach

• Contribute in painting display in vaccination room

• Ensure filling name based post campaign format for missed

children and forwarding it to school lead

• Identify a room where children are asked to move after

vaccination.

• If possible mark an area for observing children after

vaccination ( keep under observation for 30 minutes)

• Make Left out children list same day evening (refer to format2-B)


Role of School team leaders / Class leads On Day Of Vaccination

Follow the simple strategy of taking

one child at a time in vaccination

room Ensure there is a place to wait before the child gets into

vaccination room


Motivating students

• The vaccinated children have to be observed for at least

30 minutes

• Ensure that every class greets

their first 5-7 children going

for vaccination with an

applause (claps). This boosts

confidence.

Training Workshop for Measles-Rubella

Vaccination Campaigns 47





4. Engage students



children


Sr

No

Day of

vaccinationClass

Total Target

Children in school

No of Children

vaccinatedActivity Status

Day -1 Completed/Ongoing




* In case the activity is >1 day planned in school then the data reporting officer should mention day/date wise report till activity compilation

Signature Principal

School nodal person for MR Campaign vaccination (Name & Tel number): _________________________

School name: __________________________________________

Address (Village/Urban area): ______________________________________________ Encircle: Govt/ Private/ Aided

School fills this up and shares with Planning unit / Block level

Date of vaccination % achieved

Total

Board of school: ICSC/CBSC/State board/other (specify)

Total no days activity planned in school: 1/2/3/4/5/6

Class wise School MR Campaign Coverage Report

Principal name & Telephone number: ______________________

State: ____________ District: __________________ Block/urban area: ________________ Planning unit: ________________

MR Campaign FORM - 2E

Daily Class wise coverage to Principal

Planning unit: ________________

Sr

NoName of school

Total Target

Children in schools

No of Children

vaccinated

%

achieved

No days activity

planned in

school

Activity Status

Completed/Ongoing

Signature of MO

in charge

Date

Total no of school in block/Area: ______________________

School wise Block/Planning unit MR Campaign Coverage ReportMO incharge of Planning unit / Block level fills this up and send it to district MR Campaign FORM - 2F

State: ____________ District: __________________ Block/urban area: ________________________

TotalDaily school wise coverage

to planning unit/ Block MO incharge

Sr

NoBlock Name No of Schools

Total Target

Children in schools

No of Children


Completed/Ongoing

Signature of DIO

Date % achieved

Block wise district level MR Campaign Coverage ReportDistrict DIO will fill this and share with state MR Campaign FORM - 2G

State: ____________ District: __________________ No of blocks/planning units: ____________

Total no of school in district:

Total

Daily planning unit/Block wise

coverage to District (Immunization

officer)

Sr

NoDistrict Name No Of Schools

Total Target

Children in schools

No of Children


Completed/Ongoing

Signature of SEPIO

Date % achieved

District wise state level MR Campaign Coverage ReportDistrict will fill this and share with state MR Campaign FORM - 2H

State: ______________________________ No of districts ____________ Total no of school in State: __________________________

Total

Daily District wise coverage to

District (Immunization officer)

After Vaccination is completed


• The school and class leads should immediately

calculate the vaccination coverage in school

– Before vaccination session finishes Class teachers to make list

of only those students who could not be vaccinated on that day

along with the reason (refer form ) for follow up of students

More than 95 % coverage

Less than 95% coverage

Collecting list of all

schools/madrasas/

nurseries/play schools/

educational institutions

Collect school-wise

number of children of

target age group / class &

section wise(Submission

of Format 1 by school to

HF)

School engagement during preparations

Principals/Heads orientation

(+ 1 nodal teacher)

Principal & Nodal teacher to orient

all class teachers / subject teachers

Each class teacher will orient /

sensitize students & write in

blackboard / diaries / share MR

information card

School will organize Parents-

teachers meeting (PTM) &

sensitize the parents

Preparation of School

Microplan by ANM/Health

Facility

Planing Sensitization/Advocacy

Support Requested from Schools

• Sharing of Information and details by school authority to Health Facility.

• Submission of completed Format 1 by School to HF.

• Identification of One Nodal person for MR campaign.

• Orientation of All Class leads on MR campaign

• Sensitization of Parents and conducting PTM for MR Campaign.

• Sensitization and orientation of students on MR campaign.

• Support in Microplaning of School sessions in consultation with MOICs/ANM.

• Deployment of adequate staff on the day of MR vaccination(3 teachers+1 Nodal Teachers).

Waiting for vaccination…….

Improved communication of health delivery staff & education

staff pre, during & post vaccination

(Starts & ends with smiles)

Delighted after vaccination

Madarasa

Monastery Convent school

Play school

If your school

records above 95%

coverage the MR

Captains and

warriors and class

teachers should

hoist the flag the

same day/ next day

until the campaign

period ends.

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60

Thankyou

Documents

RATIONALE FOR MR VACCINE INTRODUCTION · parents about PTM /interaction ( SMS, Whatsapp, e mails, Student diary message, school website Provide links to key information Promotion