Frequency and Reasons for Vaccination Failure against Measles among Pediatric Cases at a Tertiary Care Hospital of Karachi

Abstract

Objective A nationwide measles–rubella (MR) vaccination campaign was executed in Pakistan in November 2021. Despite that, there was a persistence of new measles cases. Thus, we designed this study to determine the measles vaccination status in patients with measles and to determine the reasons of missed vaccination during the campaign. Methods We reviewed medical records of measles patients >1 month to 12 years of age, presenting to the pediatric emergency of a tertiary care hospital of Karachi, Pakistan, during January to June 2022. We recorded patients' demographics and vaccination status. Measles patients who were hospitalized were reviewed to see if the child has or has not received vaccination during the MR campaign and what were the reasons for missed vaccination. Results A total of 1,058 children presented with measles out of which 52.9% were male. The mean age of the patients was 2.2 years. Excluding 24.3% of the patients because of age <9 months, 800 (75.6%) patients were eligible for measles vaccine. Out of these, 80% received the vaccine (94.6% had one dose and only 5.3% had two doses). Among the 98 admitted patients, 68 (69.3%) were eligible for vaccination during the MR campaign, out of which 88.2% did not get the vaccine. Common reasons of missed vaccination were: lack of knowledge of the campaign (36.6%), impossibility to find vaccination facility (23.3%), and lack of trust in vaccines (15%). Conclusion Most of the hospitalized measles patients had missed the vaccine during the MR campaign, mostly because of lack of knowledge of the campaign. This calls for devising strategies to improve coverage of vaccination services.