All states must intensify efforts to inoculate children who have either missed their measles vaccination or are due for it, the health ministry has directed to ensure no child is left unvaccinated, officials familiar with the matter said on Saturday.

A total of 26.36 million children out of the eligible 26.38 million received their first dose of measles containing vaccine (MCV) in 2022-23, according to data shared by the health and family welfare ministry.

Around 21,310 children missed their first dose during that period, the health ministry said, calling recent reports that mentioned an estimated 1.1 million children in India missing their first measles vaccine dose in 2022 as “ill-informed and inaccurate”.

“Covid was a setback that impacted a lot of programmes, not just in health but other departments as well. It did not take much time for the government to put things back on track and expand the coverage,” a government official said, seeking anonymity. “Whoever is left will be covered soon.”

Measles is a highly infectious viral disease that can sicken young children. It has a basic reproduction number (R0) of 12 to 18 by most estimates, which means one infected person can pass it on to 12 to 18 others, and each of those to a similar number further. The disease is known to be fatal among children who are malnourished.

Maharashtra and Kerala reported localized outbreaks of measles last year.

Several initiatives have been taken by the government in coordination with the states to ensure all children, either unvaccinated or partially vaccinated, receive all missed or due doses of the MCV. The catch-up vaccination age for the administration of MCV has been increased from two to five years in the periodic immunization intensification activities.

Two iterations of Intensified Mission Indradhanush were carried out in 2021 and 2022 to vaccinate all unvaccinated and partially vaccinated children with missed or due doses of vaccines. Another iteration was carried out in 2023, with a special focus to increase the coverage of MR (measles rubella) vaccine in children of up to five years of age.

An MR vaccination campaign was carried out in Delhi and West Bengal, where all children in the age group of nine months to 15 years were inoculated. The coverage in both the states reached at least 95%, according to government data.

“Several States have carried out supplementary immunization activities and outbreak response immunization wherein a total of 30 million children have been vaccinated with an additional dose of MR vaccine,” the health ministry said in a statement.