Introduction strategy of a second dose measles containing vaccine in India.

of childhood morbidity and mortality in India. Although the true burden of measles is difficult to quantify, only a small proportion of cases seek treatment in the formal health sector, infection with measles virus is ubiquitous throughout the country. A recent review of Indian published literature shows the median case fatality ratio (CFR) of measles to be 1.63% (range: 0%-30.0%) [1]. Deaths from measles occur mainly in infants and young children and are primarily due to complications of the infection such as pneumonia and diarrhea. Malnutrition and young age at infection are risk factors associated with measles mortality. Recent studies estimate that 80,000 Indian children die each year due to measles and its complications amounting to 4% of under-5 deaths [2]. The distribution of these deaths is not homogenous but is concentrated in states with the poorest performing immunization programs [3-5].