I read the paper “mass measles vaccination campaign in Aila Cyclone-affected areas of West Bengal, India” by Malik and colleagues published in the December, 2011 issue of IJMS. The paper described a program of mass measles vaccination that was a good experience for health authorities.1 However, some issues should be considered in health policies for the prevention of measles. Measles is a highly contagious respiratory viral infection, and despite available vaccine, it causes a high mortality in developing countries.1,2 There was an outbreak of measles in Iran in 2003, and more than 11,000 measles patients, some of whom were adult with threatening infection, were located.2 More than 33 million of people with an age range of 5-25 years were vaccinated. The vaccination led to protection against measles in 98.6% of subjects. This led to reduction of the prevalence of the disease to zero except for few cases of immigrants from neighboring countries.3 After the mass vaccination, children have been vaccinated routinely against measles, and there has been no need for vaccination outside of Expanded Program on Immunization (EPI) program.4
The principal reasons for outbreak of measles even in disasters include inadequate vaccination coverage, which leads to inadequate immunity against the disease,5-7 loose adherence to the vaccine cold chain,6 vaccination in the early age (less than 6 months),7 and type of vaccine.7
The ineffectiveness of mass vaccination program against measles in India reported by Mallik and colleagues 1 might be related to early age of the participants (less than six months), shortage of funds and financial support, inadequate coverage (they had 70% coverage, whereas it should be more than 95%), destruction of public infrastructure by disaster (cyclone), and lack of pilot study to establish immunity against measles.