Over 70,000 children in Kathmandu Metropolitan City, between the ages of six months to five years, have been deprived of measles-rubella vaccines.

While health facilities in most other districts across the country have either completed or are about to complete the inoculation drive— the first phase of which started on February 13, health facilities in Kathmandu have not even got started.

"We could not start the drive due to the lockdown," Narendra Bajracharya, chief of the health department at the Kathmandu Metropolitan City, told the Post.

Health facilities in Kathmandu were supposed to launch the month-long vaccination drive beginning April in the second phase. The nationwide lockdown began on March 24.

"It is not so easy to start the campaign while maintaining the social distancing rule and safety of the people," Bajracharya said, though the vaccination programme was launched despite the lockdown in other parts of the country, including some municipalities within Kathmandu itself.

The campaign was not launched only in the metropolis. Even the regular immunisation programme has not taken place in all 32 wards of Kathmandu.
The government provides 11 vaccines under its regular immunisation programme to prevent vaccine-preventable diseases.

After measles outbreaks were reported in several parts of the country, including in Kathmandu Valley, during the lockdown period, the Ministry of Health and Population had directed health facilities across the country to resume the inoculation programme.

The city’s health department is under pressure to complete the vaccination programme as the end to the current fiscal year draws closer.

Bajracharya said the Department of Health Services has already notified the city office that the budget for measles-rubella vaccination campaign will not be extended to the next fiscal year.

"I think the campaign will not be effective this time, as thousands of children have returned to their villages during this lockdown period. Furthermore, we cannot expect to resume the programme while ensuring all safety measures against the coronavirus," he said.

Coverage of health programmes including immunisation remains very low in Kathmandu metropolis compared to even some remote parts of the country.

Nali Bajracharya, another official at the health department of the city office, told the Post that the coverage of most health programmes in Kathmandu are 60 percent or less.

According to her, the lack of exact population data has also contributed to the low vaccination and other health service coverage in Kathmandu.
"The number of floating populations is very high in Kathmandu, which increases the risk of people missing from health programmes," she said.

Basanta Shrestha, public health officer at the immunisation section of the Family Welfare Division under the Department of Health Services, told the Post that the chance of large scale outbreak of vaccine-preventable disease in coming months will be high in Kathmandu if children continuously missed their regular vaccines.

"We have already witnessed several measles outbreaks and deaths in the last two months including in Kathmandu and Lalitpur," Shrestha said. "If the immunisation programme is not resumed immediately, we cannot exclude the chance of large scale outbreak."

Several children in the Mulpani area of Kathmandu and Khokana of Lalitpur were infected with measles last month.

Dr Jhalak Sharma, chief of the immunisation section at the Family Welfare Division, also said that there is a risk vaccine-preventable diseases breaking out in Kathmandu as many children have missed their vaccination due to the lockdown.

"We will hold a meeting with the officials concerned at the metropolis as well as the elected representatives to draw their attention about this risk," said Sharma.