Measles Control in Viet Nam

Viet Nam has reported more than 3,500 confirmed measles infections since the beginning of 2014. Photo courtesy of WHO.

Nguyen Thi Thanh Thuy watches over her 2-year-old son as he takes quick, short breaths in a quarantined intensive care unit (ICU) at Hanoi’s National Paediatric Hospital. Like the 40 other children in the unit, Thuy’s son has a severe measles infection. Since the beginning of 2014, Viet Nam has reported more than 3,500 confirmed measles infections. More than 86 percent of those infected have not been immunized or their vaccination status is unknown.

In Hanoi, the National Pediatric Hospital has treated more than 1,280 measles patients and over 100 children have died from measles related complications. Among those who died, half of the children were less than nine months old.

Measles is still one of the leading causes of death in young children worldwide. A highly contagious disease, it quickly attacks children who are unvaccinated or under-vaccinated. Children who have underlying health conditions or are malnourished are particularly vulnerable if they are infected with measles, and may die of pneumonia, diarrhoea and encephalitis as a result.
 
Before the introduction of the measles vaccine in 1980, more than 100,000 cases were reported yearly in Viet Nam. By 1988, measles vaccine coverage was at 90 percent which significantly reduced cases of measles to less than 10,000 per year but not enough towards complete elimination.

Since measles is so infectious, a country needs to ensure that at least 95 percent of all children receive two doses of the vaccine to prevent outbreaks.

“Immunization is critical to reducing child deaths in Viet Nam, says WHO representative Dr. Takeshi Kasai. “High vaccination coverage for measles among children in Viet Nam will prevent the disease from spreading, and will break the cyclical nature of the most recent measles cases. “

As the number of measles infections increase, doctors and nurses are working around the clock to treat the most serious cases and to reduce overcrowding in the hospitals. Viet Nam’s Ministry of Health has responded swiftly, mobilizing its health system to control the measles infections, treat patients and vaccinate children at risk.

Hospitals and health facilities have been given extra personnel and equipment, while immunization workers across the country are providing measles vaccines to those children who have missed their routine doses.

“In my 10 years working here, I have not seen this many young children with measles,” explains Dr. Phan Huu Phuc, who is treating the most severe cases at the National Paediatric Hospital. “At one point, the paediatric ICU and infection disease department were overcrowded, but we were able to quickly mobilize resources to develop a new wing dedicated for measles patients. It allows us to treat moderate to severe cases of measles patients, particularly those who have acute respiratory distress and might require mechanical ventilation support" he said.

Nguyen Thi Thanh Thuy thinks back to a year ago when she decided not to vaccinate her son against measles. Like many other parents in Viet Nam, she had read media reports about serious side effects, including death, which some speculated were linked to routine immunization.

“I became so afraid of the side effects of vaccines that I decided not to take my son to get his routine shots. Now I have learned my lesson,” she says, “and I am telling my friends to get their children vaccinated so they don’t have to suffer like my son does today.”

Globally, the measles vaccine has been in use for 50 years. It is safe, effective, inexpensive, and has played a major role in reducing the number of measles deaths worldwide.

Over the past 15 years, with the support of WHO, the UN Foundation and UNICEF, Viet Nam bolstered its commitment to reduce the incidence of measles outbreaks and has periodically conducted measles vaccination campaigns for children between the ages of nine months and 10 years, including a routine second dose, in an effort to ensure complete immunity.

Viet Nam provides a locally produced measles vaccine for all eligible children, free of charge since 2011. A national measles and rubella vaccination campaign for children between 9 month and 14 years of age is planned for later this year.

Over the last few weeks, people have rushed to get their children vaccinated against measles. “This is the most important preventive measure people can take to protect themselves, their families and their community,” explains Dr Takeshi Kasai. “Successful vaccination programmes are like successful societies: they depend on the cooperation of every individual to get immunized in order to ensure the good health for the whole country.”

Source: World Health Organization