title: Cluster survey evaluation of a measles vaccination campaign in Jharkhand, India, 2012.
abstract: BACKGROUND
  India was the last country in the world to implement a two-dose strategy for measles-containing vaccine (MCV) in 2010. As part of measles second-dose introduction, phased measles vaccination campaigns were conducted during 2010-2013, targeting 131 million children 9 months to <10 years of age. We performed a post-campaign coverage survey to estimate measles vaccination coverage in Jharkhand state.
  
  
  METHODS
  A multi-stage cluster survey was conducted 2 months after the phase 2 measles campaign occurred in 19 of 24 districts of Jharkhand during November 2011-March 2012. Vaccination status of children 9 months to <10 years of age was documented based on vaccination card or mother's recall. Coverage estimates and 95% confidence intervals (95% CI) for 1,018 children were calculated using survey methods.
  
  
  RESULTS
  In the Jharkhand phase 2 campaign, MCV coverage among children aged 9 months to <10 years was 61.0% (95% CI: 54.4-67.7%). Significant differences in coverage were observed between rural (65.0%; 95% CI: 56.8-73.2%) and urban areas (45.6%; 95% CI: 37.3-53.9%). Campaign awareness among mothers was low (51.5%), and the most commonly reported reason for non-vaccination was being unaware of the campaign (69.4%). At the end of the campaign, 53.7% (95% CI: 46.5-60.9%) of children 12 months to <10 years of age received ≥ 2 MCV doses, while a large proportion of children remained under-vaccinated (34.0%, 95% CI: 28.0-40.0%) or unvaccinated (12.3%, 95% CI: 9.3-16.2%).
  
  
  CONCLUSIONS
  Implementation of the national measles campaign was a significant achievement towards measles elimination in India. In Jharkhand, campaign performance was below the target coverage of ≥ 90% set by the Government of India, and challenges in disseminating campaign messages were identified. Efforts towards increasing two-dose MCV coverage are needed to achieve the recently adopted measles elimination goal in India and the South-East Asia region.
authors.affiliation: Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Heather M
authors.initials: HM
authors.lastname: Scobie
authors.affiliation: National Polio Surveillance Project, World Health Organization Country Office, New Delhi, India.
authors.forename: Arindam
authors.initials: A
authors.lastname: Ray
authors.affiliation: National Polio Surveillance Project, World Health Organization Country Office, New Delhi, India.
authors.forename: Satyabrata
authors.initials: S
authors.lastname: Routray
authors.affiliation: National Polio Surveillance Project, World Health Organization Country Office, New Delhi, India.
authors.forename: Anindya
authors.initials: A
authors.lastname: Bose
authors.affiliation: National Polio Surveillance Project, World Health Organization Country Office, New Delhi, India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Bahl
authors.affiliation: National Polio Surveillance Project, World Health Organization Country Office, New Delhi, India.
authors.forename: Stephen
authors.initials: S
authors.lastname: Sosler
authors.affiliation: Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Wannemuehler
authors.affiliation: Ministry of Health and Family Welfare, Government of India, New Delhi, India.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Kumar
authors.affiliation: Ministry of Health and Family Welfare, Government of India, New Delhi, India.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Haldar
authors.affiliation: Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Abhijeet
authors.initials: A
authors.lastname: Anand
mesh_terms: D002648:Child; D002675:Child, Preschool; D003710:Demography; D005260:Female; D006306:Health Surveys; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D008457:Measles / Q000453:epidemiology* / Q000276:immunology*; D008458:Measles Vaccine / Q000276:immunology*; D012424:Rural Population / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D008458:Measles Vaccine