The health authorities are now approaching micro-planning in mitigating the gap in the measles vaccination coverage after the recent vitamin A capsule campaign reached a higher number of children.
The move comes as deaths of children continued to be reported even after three months of special vaccination. The authorities forecasted that the outbreak would come under complete control in one to two months as the half-baked vaccination campaign left many children unvaccinated.
Epidemiologists feared that about 10 million children remained out of the coverage.
Meanwhile, six more children died with symptoms consistent with measles in the last 24 hours until 8:00am on Wednesday, bringing the country's combined figure of confirmed and suspected measles-related deaths to 803.
The Directorate General of Health Services (DGHS) and its Expanded Programme on Immunization (EPI) could not find the exact cause of two different figures of targeted children for the special measles campaign and Vitamin A campaign.
DGHS in April this year primarily targeted about 18 million children to be vaccinated against measles while it completed vitamin A capsule campaign last month after 14 months of break with a targeted coverage of about 24 million children across the country.
EPI officials, however, told the FE that they reached about 22.3 million after the single-day campaign ended last month.
Now, they have started micro-planning to cover the children missed in the vaccination.
They, too, could not explain how the gap emerged in the two separate campaigns even after being conducted by the same people of the EPI.
EPI Assistant Director Dr Hasanul Mahmud told the FE that they have started micro-planning to bring the unvaccinated eligible children.
"We approach micro-planning aligning the Bangladesh Bureau of Statistics (BBS) data to probe the gap and take action to have the unvaccinated eligible children under vaccination. The special campaign has not closed, children are still coming," he added.
The latest Vitamin A campaign covered about 22.3 million children while the target was 24 million, according to the official.
"This result of the micro-planning will be used for the routine measles vaccination so that no one remains unvaccinated," he added.
Many of the measles infected children died even at the age of below six months while many of them were above the age of five years which made the situation difficult and it would take some more time to grip the infection, said the EPI official.
According to the latest research Bangladesh Shishu Hospital and Institute, about 18 per cent children died in measles infections and with like-symptoms who were below six months and 52 per cent were below nine months.
Meanwhile, 91 per cent of the children they surveyed (337 children) died from measles and had not received any vaccine.
DGHS Additional Director General Prof Zahid Raihan told the FE that micro-planning could reduce the gap between the two campaigns and bring the unvaccinated group under coverage.
He said, referring to the field officials and stakeholders, that there are still some misconceptions among the people not to take vaccines, but no reservation towards vitamin consumption-these are some obstacles because some children are still out of vaccine coverage.
Epidemiologists, however, blamed the lack of micro-planning before the campaign was designed.
Epidemiologist Mohammad Mushtuq Husain blamed that the EPI relay old data of BBS, civil surgeon offices and what they had in hand in the Dhaka office in the special measles campaign.
He believed that about 10 million children missed the measles vaccination campaign.
Some DGHS officials talking to the FE, preferring not to be named, also echoed the same, adding that the campaign was based on 2022 BBS data.
Husain, however, said such a gap is common in such emergencies and the government was appreciative of the immediate response and initiation of the nationwide measles vaccination.
Poor people often could not come to the vaccine booth, thus the health authorities must ensure visiting homes and confirm coverage, he advocated.
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