Measles campaigns as a delivery platform for high-impact maternal & child health interventions in India (2011-2016)

The measles vaccine has made the largest single contribution to reducing child mortality among all vaccines, and vaccination campaigns are frequently used to boost measles vaccine coverage. This project investigated whether we could deliver campaigns differently to achieve greater impact and equity.

(c) Raah Health & Social Development Foundation

Project

With colleagues from the London School of Hygiene and Tropical Medicine, Harvard, and the University of Toronto, we developed policy models leveraging India’s Million Deaths Study data to evaluate the mortality impact of India’s 2010-2013 measles campaigns, and to assess the benefit of an alternative (hypothetical) strategy including additional high-impact health interventions along with measles vaccine in the campaign platform.

Findings

We found that, in India, a measles vaccination campaign including feasible, high-impact interventions could substantially increase lives saved and mitigate gender-related inequities in child mortality compared to a campaign delivering measles vaccine alone. Results are relevant to future measles-rubella SIAs in India and globally.(1, 2)

Impact

Based on comprehensive evidence, including our study, the Gavi Alliance has begun to encourage integrated intervention delivery through the immunisation platform when planning for new vaccine introductions and conducting campaigns. Policy decisions are multifactorial; our research contributed at the right juncture.

Led by Professors Verguet and Jit, the project team also developed a mathematical model for measles (3, 4) used by Gavi, the Bill & Melinda Gates Foundation, and other global partners.

Research

1. Johri M, Verguet S, Morris SK, Sharma JK, Ram U, Gauvreau C, Jones E, Jha P and Jit M: Adding interventions to mass measles vaccinations in India. Bull World Health Organ 2016, 94(10):718-727. http://dx.doi.org/10.2471/BLT.15.160044

2. Johri M, Sharma JK, Jit M and Verguet S: Use of measles supplemental immunization activities (SIAs) as a delivery platform for other maternal and child health interventions: opportunities and challenges. Vaccine 2013, 31(9):1259-1263. https://doi.org/10.1016/j.vaccine.2012.09.044

3. Verguet S, Johri M, Morris SK, Gauvreau CL, Jha P and Jit M: Controlling measles using supplemental immunization activities: a mathematical model to inform optimal policy. Vaccine 2015, 33(10):1291- 1296. https://doi.org/10.1016/j.vaccine.2014.11.050

4. Verguet S, Jones EO, Johri M, Morris SK, SuraweeraW, Gauvreau CL, Jha P and Jit M: Characterizing measles transmission in India:  a dynamic modeling study using verbal autopsy data. BMC Med 2017, 15(1):151. https://doi.org/10.1186/s12916-017-0908-3