The impact of measles immunization campaigns in India using a nationally representative sample of 27,000 child deaths

Abstract

India comprises much of the persisting global childhood measles mortality. India implemented a mass second-dose measles immunization campaign in 2010. We used interrupted time series and multilevel regression to quantify the campaign’s impact on measles mortality using the nationally representative Million Death Study (including 27,000 child deaths in 1.3 million households surveyed from 2005 to 2013). 1–59 month measles mortality rates fell more in the campaign states following launch (27%) versus non-campaign states (11%). Declines were steeper in girls than boys and were specific to measles deaths. Measles mortality risk was lower for children living in a campaign district (OR 0.6, 99% CI 0.4–0.8) or born in 2009 or later (OR 0.8, 99% CI 0.7–0.9). The campaign averted up to 41,000–56,000 deaths during 2010–13, or 39–57% of the expected deaths nationally. Elimination of measles deaths in India is feasible.