Measles Control in Nigeria: the Case for a Two-dose Vaccine Policy

Abstract

Summary : Despite all the efforts expended on routine immunization since the era of Expanded Programme of Immunization (EPI) later called the National Programme of Immunization (NPI), measles remains a disturbing cause of morbidity and mortality in Nigeria and other developing countries. Currently, measles is the commonest cause of vaccine preventable deaths in Africa. Complications of measles such as encephalitis; as well as auditory and visual impairment cause permanent disabilities in patients, thus reducing their quality of life. Measles vaccine coverage of 59 percent in infancy in 1988 and 35 percent in 2003 remains low in Nigeria. The WHO and UNICEF have highlighted the need to improve vaccine coverage and effectiveness to at least, 95 percent for protective herd immunity and effective measles control. This can be facilitated through a two-dose measles vaccine policy as is being practised by most western and some African countries who are pursuing measles control and elimination programmes. A second dose of measles vaccine given either as routine or as a supplement is expected to offer a second opportunity to children who missed their first dose at nine months, while serving as a booster to previously vaccinated children with vaccine failures. In this communication, the need for a review of the current NPI schedule for measles vaccine is stressed. Such a review may contribute towards reaching the 4th millennium development goal of reducing by two thirds, the mortality rate among under-five children by the year 2015.