The Government of Myanmar is committed to achieve WHO South-East Asia Regional goal of measles elimination and rubella control by 2020. In order to accelerate progress towards this goal, under the leadership of the Ministry of Health with support from WHO, GAVI and UNICEF, Myanmar conducted a National Measles Rubella Vaccine campaign in January-February 2015 targeting all children in the age group of 9 months to 15 years irrespective of their previous immunization status. This wide age range cohort was decided based on the local Measles Rubella epidemiological situation.
The National MR campaign was conducted in two phases targeting an estimated 17.4 million children. The first phase was conducted in January 2015 targeting school children 5 years to 15 years in approximately 45,000 schools, government, private and monastic schools. The second phase targeting approximately 65,000 villages/urban wards was conducted in February 2015 vaccinating children from 9 months to 5 years of age plus children missed out in school phase, children who don’t attend school. In order to achieve high quality of coverage, extensive preparatory activities were undertaken such as establishment of Central Executive Committee, development of planning, technical training guidelines for health workers, school teachers, and volunteers. Village/ward-wise micro plans, master list of all eligible children, advocacy meeting with various stakeholders like department of education, local authorities, Myanmar Medical Association, Myanmar Maternal and Child Welfare Association (MMCWA) and National & International NGOs. Extensive social mobilization was carried out in all communities using TV/Radio as mass media, displaying posters, banners, stickers and interpersonal distribution of invitation cards to families. All health workers were re-trained with special emphasis on injection safety practices, prevention and management of adverse events following immunization (AEFI). The cold chain and vaccine, logistic supply chain was thoroughly reviewed and strengthened. WHO deployed additional international technical experts to support the preparedness & planning.
The campaign reached approximately 94% of the target population. Country-wide, mobilization of nurses, teachers and efforts of countless community leaders resulted in an excellent coverage. Even in areas of conflict and intercommunal tensions such as Rakhine and Kachin States, unprecedented mobilization of health staff, volunteers and community leaders helped coverage reach levels comparable to the national average. The reasons for some unimmunized children in the population were sickness or parents traveling and some children in remote inaccessible areas. 4 major AEFI cases were recorded during the campaign, however, detailed investigation did not show any association of these AEFI with MR vaccine. The success of MR campaign is attributed to high level of political commitment, high quality preparedness supported by technical assistance from WHO and UNICEF, dedicated health staff, strong support from education department, local authorities, and volunteers. Starting May 2015 rubella vaccine (MR) will be part of National routine immunization program.