The Union government on Wednesday told states and Union Territories to consider administering an additional dose of the vaccine to prevent measles and rubella to children aged nine months to five years in vulnerable areas.

P Ashok Babu, the joint secretary of the Union health ministry, made the statement in a letter sent to all states and Union Territories. The ministry issued the communication amid a sharp spike in cases of measles in Mumbai.

Mumbai has registered 233 measles cases this year till Wednesday, The Indian Express reported. The city has also registered nine deaths due to the disease.

The deaths due to measles have also been reported in the towns of Bhiwandi (3) and Nalasopara (1) – both of which are located within the Mumbai Metropolitan Region.

The health ministry on Wednesday said that the rise in cases is a concern for the public health. “It is also clear that in all such geographies, the affected children were predominantly unvaccinated and the average coverage of MRCV [Measles and Rubella Containing Vaccine] among the eligible beneficiaries is also significantly below the national average,” the government said.

Babu said that in this context, a meeting of technical experts was held on Wednesday under the chairpersonship of the member (health) of the NITI Aayog. The ministry advised states and Union Territories to consider administering an additional vaccine dose based on inputs from the meeting.

The official also said that it should be ensured that children have been administered the first and second doses of the vaccine as per the regular inoculation schedule.

“The disease is known to witness a surge in cases of numbers from November to March, annually,” the health ministry said. “Hence, an active fever and rash surveillance mechanism needs to be strengthened for early case identification.”

The Centre also told the Maharashtra government to earmark wards and beds in dedicated health facilities to ensure effective management of measles cases.

On Wednesday, the Union government also set up high-level teams to deal with measles outbreaks in the cities of Ranchi, Ahmedabad and Malappuram, The Hindu reported. The teams will help state health departments put in place public health measures and implement control and containment norms.

‘40 million children missed measles vaccine in 2021’

A report published by the World Health Organization and the United States’ Centers for Disease Control and Prevention said on Wednesday that in 2021, a record high of nearly 40 million children missed a measles vaccine dose.

Out of these, 25 million children missed their first dose while 14.7 million missed their second dose, the report said. It noted that measles vaccination coverage has steadily declined since the beginning of the coronavirus pandemic.

“The paradox of the pandemic is that while vaccines against Covid-19 were developed in record time and deployed in the largest vaccination campaign in history, routine immunization programmes were badly disrupted, and millions of kids missed out on life-saving vaccinations against deadly diseases like measles,” World Health Organization chief Tedros Adhanom Ghebreyesus said.