Fourth phase of Mission Indradhanush (2017-18) has been named as Intensified Mission Indradhanush (IMI). It aims to rapidly build up immunization coverage by December 2018 and sustain thereafter through routine immunization.

IMI will be implemented in 108 districts across 16 states, 52 districts across 8 north eastern states, and 17 urban areas across 8 states, with special focus on children up to 2 years of age and pregnant women. This intensified mode will be characterized by better convergence with other departments besides health, intensive monitoring by health ministry and partners, prioritization of urban areas, and rewards on achievement of targets .

Yes. Vaccines should be given to children as per the guidelines irrespective of their original state or place of residence, or the length of stay. Example, if a three-year child comes to a JE endemic state for a month from another place where JE vaccination is not provided under UIP. This child should be given one dose of JE vaccine while s/he is residing in the endemic state where vaccine is provided under UIP.

Yes. Even if the child has received the age-specific and recommended vaccines in routine immunization, s/he should be given “additional” doses of the vaccine during the campaigns such as pulse polio or measles/MR campaigns. Also, if a child has received doses of a vaccine during a campaign, s/he should complete the vaccine schedule through routine immunization as well. These additional doses during campaigns can be given/ administered irrespective of days since last dose was received. For example, if a child has received second dose of OPV three weeks before, s/he can still receive an additional dose during the pulse polio campaign.

MR/ MMR vaccines have been in use in private sector for a long time. Now, Rubella vaccine is being introduced in UIP as Measles-Rubella (MR) vaccine to prevent rubella infection in children and young adults. Rubella is a viral disease, and during pregnancy this infection can cause abortion, stillbirth and may also lead to multiple birth defects in the new-born (like blindness, deafness, heart defects, development delays, and many other lifelong disabilities), known as Congenital Rubella Syndrome (CRS). This condition is a significant public health problem, as India accounts for around one-third of all children born worldwide with CRS. Introduction of MR vaccine in UIP is an interim strategy to ensure measles elimination and rubella control in South-East Asia Region by 2020.

Both boys and girls are equally susceptible and at risk of getting rubella infection. Boys who get infected may cause transmission of rubella virus to unvaccinated children and young adults, so both boys and girls should be vaccinated with MR vaccine during MR campaigns and in routine immunization.

MR vaccination campaign is a special campaign to vaccinate all children in the age group of 9 months to less than 15 years with one additional dose of MR vaccine, irrespective of their previous vaccination status with measles vaccine. This wide age- range campaign has been recommended by the NTAGI as this will provide a second opportunity for those children who were left out due to either vaccine failure or failure to vaccinate. This will ensure attainment of high levels of population immunity by reaching wide age group, including children missed under routine immunization program.

The purpose of conducting an MR campaign is to boost the immunity, protect children from infection, and eliminate transmission of these disease-causing agents from the community by vaccinating 100 percent target children with MR vaccine. Further, follow-up campaigns may be required to sustain high population immunity against both measles and rubella besides maintaining high routine immunization coverage for both the antigens.

Yes. The Measles-rubella (MR) vaccine used in campaigns as well as immunization programme is a live attenuated vaccine and safe and effective. The vaccine being used is WHO pre-qualified and is used in India, along with several other neighbouring countries like Bangladesh, Sri Lanka, Nepal, and Myanmar. Some children may have transient, self-limiting, low fever and mild rash, which is due to the immune response elicited by the vaccine, and should not be a cause of concern.