The Ministry of Health has proposed that Ho Chi Minh City consider vaccinating children aged 6-8 months against measles, as recommended for high-risk areas, instead of waiting until 9 months of age as usual.
The opinion was expressed by Dr. Duong Thi Hong, Deputy Director of the Central Institute of Hygiene and Epidemiology, Ministry of Health, when working on measles prevention in Ho Chi Minh City on the afternoon of August 29. Currently, the Ministry of Health recommends that the first dose of measles vaccine be given to children at 9 months of age and the second dose at 18 months of age. In fact, in recent times, many measles cases in Ho Chi Minh City have been children under 9 months of age – a group that is not old enough to be vaccinated.
According to Ms. Hong, the World Health Organization (WHO) recommends measles vaccination for children under 9 months in high-risk areas and epidemic areas. The measles vaccine produced by the Center for Research and Production of Vaccines and Medical Biologicals (POLYVAC) has been supplied for more than 15 years. Four years ago, this unit conducted clinical trials on safety and immunity in children aged 6-8 months, and was approved by the Drug Administration for vaccination.
“HCMC is reviewing measles outbreaks in localities and considering prescribing a single dose of measles vaccine for children aged 6-8 months, especially children with underlying diseases treated in hospitals, at risk of exposure to measles, and susceptible to severe complications when infected with measles,” Ms. Hong said, adding that when HCMC has declared an outbreak, vaccination can be carried out according to plans suitable to the local situation, instead of following the general instructions of the Ministry of Health.
At that time, children 6-8 months old who receive measles vaccine will be counted as dose 0. Next, children will receive the first and second doses at 9 and 18 months of age, respectively, according to the instructions of the Ministry of Health.
Dr. Nguyen Van Vinh Chau, Deputy Director of the Ho Chi Minh City Department of Health, said that from August 31, Ho Chi Minh City plans to organize a city-wide vaccination campaign. The first phase will last about a month, vaccinating all children aged 1-5, children in the high-risk group aged 6-16, who have not received two doses or have unknown medical history. Medical staff, people working at medical facilities at risk of contact with people with measles, and caregivers of children in the high-risk group who have not received two doses will also be given priority for vaccination. In the second phase, the city will vaccinate children aged 6-10 who have not received two doses.
Currently, the citywide coverage rate for the first dose of the vaccine for children born in 2023 is only nearly 91%. No district has reached 95%. The rate of second dose vaccination for older children has not yet reached this immunity milestone.
According to Mr. Chau, Ho Chi Minh City has a very large population movement, many children from other places come to live in the area, not on the city’s vaccination management list. A random survey of 180 children in some wards and communes recorded that more than 20% of children in the area have addresses from other provinces and cities, leading to the health station not knowing to invite them for vaccination.
The city’s health sector leaders said that in the context of the number of cases continuously increasing, gradually shifting to older children and children in high-risk groups, it is necessary to implement a non-selective vaccination campaign to speed up the vaccination progress, increase vaccine coverage, quickly cover over 95% to create community immunity, and promptly control the epidemic.
Recently, many hospitals in Ho Chi Minh City have organized measles vaccinations for inpatients in high-risk groups as well as medical staff in many departments. Hospitals have increased training and triage from clinics to separate measles cases, avoid cross-infection, and prevent measles cases from entering areas treating severe patients. Ho Chi Minh City has also implemented training at the front lines, updated treatment guidelines, and avoided mass transfer of patients to the back lines, causing overload.
Children with measles who are not old enough to be vaccinated and treated at Children’s Hospital 1. Photo: Le Phuong
Dr. Nguyen Vu Thuong, Deputy Director of Pasteur Institute of Ho Chi Minh City, said that with the population movement, when implementing the vaccination campaign, Ho Chi Minh City needs to pay attention to children in boarding houses, children of workers in industrial parks, children in suburban areas – where there are high numbers of cases. Because when children get vaccinated, their parents have to take time off work. Therefore, it is necessary to coordinate with industrial parks to create favorable conditions for parents to take their children to get vaccinated.
Deputy Minister of Health Nguyen Thi Lien Huong highly appreciated Ho Chi Minh City’s proactiveness in responding to measles, with synchronous plans and measures. Regarding other epidemics such as dengue fever and hand, foot and mouth disease, the number of cases is decreasing compared to previous years. Therefore, the city is less at risk of overlapping epidemics, and can focus on preventing measles.
“Vaccination is the most effective measure, if well covered, it will create community immunity. The disease can only be stopped from spreading when community immunity reaches 95% or more,” Ms. Huong said, adding that measles is very contagious, often occurring in crowded places such as schools, bus stations, and public places. When implementing vaccination, the most important thing is to ensure safety and have a plan to handle appropriate post-vaccination reactions.
The Deputy Minister requested to continue to coordinate forces, to control the epidemic soon, in order to better perform the task of socio-economic development, especially in the context of the upcoming holidays. Connecting hospitals and the community, notifying the locality when sick children are allowed to go home to self-treat, avoiding cases of unsafe isolation, causing infection in the community.
On the afternoon of August 27, the Ho Chi Minh City People’s Committee announced a measles epidemic in order to deploy preventive measures and organize vaccinations. Since the beginning of the year, the city has recorded more than 430 measles cases, while from 2021 to 2023, there was only one positive test case. In the next two days, about 300,000 doses of measles-rubella (MR) vaccine will arrive in the city to implement the vaccination campaign.
Measles is transmitted through the respiratory tract by coughing, sneezing, close contact with an infected person or nasal secretions… The disease is characterized by fever, inflammation of the respiratory tract, conjunctivitis and rash. Children with the disease are treated symptomatically, most recover on their own. However, some groups such as children with immunodeficiency, cancer, chronic diseases, congenital heart disease… are at risk of severe progression, possibly death. Measles also weakens resistance, making children susceptible to other diseases.