Spokespersons’ Guide and Response Pro

TABLE OF CONTENTS
SECTION 1: INTRODUCTION
1a. Background
1b. Factsheet

SECTION 2: REFERENCE MATERIAL FOR MEDIA

2a. List of spokespersons
2b. Key messages for Media
2c. Myths versus facts
2d. Dos and Don’ts of handling media

SECTION 3: STANDARD RESPONSE PROTOCOL

3a. Standard response protocol at national and state level

SECTION 4: POSSIBLE SCENARIOS

4a. Sample scenarios and standard messages
1. INTRODUCTION
1a. Background
The Measles-Rubella (MR) vaccination campaign is one of the biggest campaigns
undertaken by the Ministry of Health & Family Welfare under Universal Immunization
Programme, till date. The first phase of the campaign was rolled out in Karnataka, Tamil
Nadu, Goa, Lakshadweep and Puducherry in February 2017, reaching out to children of
the age of 9 months to less than15 years.

Under the campaign, all children aged between 9 months and less than 15 years are
administered a single shot of Measles-Rubella (MR) vaccination irrespective of their
previous Measles/Rubella vaccination status or Measles/Rubella disease status. MR
vaccine is being provided free of cost across the states from session sites at schools as
well as health facilities and outreach session sites.

1b. Factsheet
Measles is one of the leading causes of death among young children, even though a
safe and effective vaccine has been available for over 40 years. It is a highly
contagious disease, caused by virus of the paramyxovirus family and spreads through
coughing and sneezing of an infected person. Measles is commonly recognizable as a
visible red rash with high fever, cough, runny nose and red eyes. Children who do not
have sufficient immunity contract the disease, if exposed. Measles can make a child
vulnerable to life threatening complications such as pneumonia, diarrhoea and brain
infection.

Rubella, although a mild viral illness, can lead to serious consequences if infected
during pregnancy. Rubella infection during early pregnancy can lead to abortion,
miscarriage, still birth, and set of congenital anomalies in the foetus and newborns
known as Congenital Rubella Syndrome (CRS), which is a cause of public health
concern. CRS is characterized by multiple defects, particularly affecting the eyes
(glaucoma, cataract), ears (hearing loss), brain (microcephaly, mental retardation) and
heart defects, many of which require costly therapy, surgeries and other expensive
care.

Both these diseases can be prevented by highly effective vaccines which offer lifelong
protection. Malnourished children should be vaccinated on a priority basis, as they
are more likely to have complications like diarrhea and pneumonia.

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FAST FACTS

As per WHO estimates, measles killed nearly 49,200 children in

2015 in the country, contributing nearly 36% to the global figures

Burden of CRS is high in countries that have not introduced rubella

vaccination.

There is no specific treatment for rubella but the disease is

preventable by vaccination

In recent years, measles deaths have declined by 51% from an

estimated 100 000 in the year 2000 to 49 000 in 2015.

It costs less than Rs. 50/- to vaccinate a child against measles and
rubella.

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 Measles Elimination and Rubella/CRS control: South East Asia
Regional Goal
In September 2013, during the 66th WHO-South East Asia Regional Committee
Meeting, India along with 10 other member countries of SEAR, resolved to
eliminate measles and control rubella/congenital rubella syndrome (CRS) by 2020.

MEASLES-RUBELLA CAMPAIGN
 The Government of India is introducing Rubella vaccine under Universal
Immunization Programme (UIP) as Measles-Rubella (MR) vaccine, which
provides protection against both measles and rubella

 The campaign was launched in February 2017 in 5 states Tamil Nadu,

Karnataka, Puducherry, Goa & Lakshadweep reaching out to 3.3 crore
children. The remaining states will be taken up in a phased manner.

 The second phase of the campaign will be launched in Andhra Pradesh,

Chandigarh, Dara & Nagar Haveli, Daman & Diu, Himachal Pradesh, Kerala,
Telangana and Uttarakhand.

 The MR vaccine is being scaled up as a wide-age range campaign, to cover

children in the age group of 9 months to less than 15 years, in a phased
manner across the country.

 About 41 crore children are expected to be covered under this campaign

across the country, making it the largest ever measles rubella campaign
launched in the world.

 Following the campaign, the combined MR vaccine will be available under

routine immunization, replacing the earlier administrated two doses of
measles vaccine. The first dose of MR vaccine will be being given at 9- 12
months and second dose at 16-24 months of age of the child.

 A single shot of the vaccine is being given to the target children during the
campaign through session sites at schools, health facilities and outreach
sites

 The MR vaccine is provided free of cost, and is given to all target age group
children, irrespective of their previous measles/rubella vaccination or
measles/rubella disease status.
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 The campaign aims to rapidly build up population immunity by reaching out
to 100% target children with MR vaccine, knocking out the disease from the
susceptible group of children and, thereby, reducing the morbidity and
mortality associated with measles and the CRS burden.

 The Measles-Rubella campaign is a part of global efforts to reduce illness

and deaths due to measles and rubella/CRS in the country.

 Measles immunization directly contributes to the reduction of under-five child

mortality. In combination with rubella vaccine, it will control rubella and
prevent CRS.

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2. REFERENCE MATERIAL FOR MEDIA

Target Age
Group - 9 to 15
years
41 crore Measles
children are immunization
expected to be directly
covered under contributes to
this campaign in the reduction of
the entire under-five child
country mortality
Measles
Rubella
Campaign
Builds
Under routine
population
immunization,
immunity by
the first dose of
reaching out to
MR vaccine is
100% target
given at 9- 12
children with
months
MR vaccine
The MR vaccine
is provided free
of cost

2a.List of Spokespersons
NAME DESIGNATION CONTACT NO. EMAIL ID

GOVERNMENT SPOKESPERSONS

Deputy Commissioner
Dr. Pradeep Haldar
(Immunization), Ministry of
(National Phone: +91 11-
Health & Family Welfare,
spokesperson) 23062728, 23062126
Government of India

Respective Secretary
Health / Mission Director /
(State spokesperson)
Director of Health

WHO SPOKESPERSONS

(National
spokesperson)

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 (State spokesperson)

UNICEF SPOKESPERSONS

(National
spokesperson)

(State spokesperson)

MEDIA QUERIES

Geetanjali Master
(National and Communication Specialist, 9818105861 gmaster@unicef.org
International media UNICEF India
queries)
Sonia Sarkar
(National and Communication Officer 9810170289 ssarkar@unicef.org
International media (Media), UNICEF
queries)
UNICEF field office
(State media queries)

Communication
Specialist from
respective state offices

2b.Key Messages for Media

 Measles is one of the leading causes of death among children despite the
availability of a safe and effective vaccine for over 40 years.
 Of the approx. 1,34,200 measles related deaths globally in 2015, 36% were from
India.
 Rubella is a contagious, generally mild viral infection which in pregnant women
may cause abortions.

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 Children born to mothers infected with rubella during pregnancy, may get
congenital defects such as blindness and deafness commonly known as
Congenital Rubella Syndrome or CRS.
 Children may also get mental retardation or issues with multiple organs.
 India is committed to eliminating measles and to control rubella and congenital
rubella syndrome (CRS) by 2020.
 For a successful campaign, all children in the target age group must be
vaccinated.
 Both diseases can only be prevented through vaccination.
 The combined MR vaccine replaces the Measles vaccine in the routine
immunization programme.

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2c. Do’s and Don’ts
It is important to keep in mind a few things while communicating (either verbally or
non-verbally) with the media.

DON'T
DO's Repeat
Prepare answers for
s objectionable
the expected questions – it only
questions reinforces
beforehand. inaccurate or
incorrect information

Correct
misstatement before Use overtly
bridging to the next technical jargon
point

Keep the statement

Say ‘no comment’
concise to reduce
without a brief
risk of
explanation
misinterpretation

If you cannot
release information,
Withhold
explain why. If you
information that is
cannot release it
available through
until later, let the
other sources
journalist know
when that will be

If you do not know Comment on facts

the answer to the and figures you are
question, say so not familiar with

Use facts, statistics

and anecdotes –
they make the
interaction more
interesting and
credible

Avoid prefixes such

as “honestly” or to
be “candid” and
other variations.

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2d. Myths versus Facts

1. Safety and Efficacy of the Vaccine

MYTH:
Measles-Rubella (MR) vaccine has adverse side-effects, impacting children’s
immunity and affecting their ability to concentrate
FACT:
a. Measles-Rubella vaccine is a safe & an effective vaccine, in use for over 40
years in many countries across the world.

b. Adverse reactions following MR vaccination are generally mild and transient -

low-grade fever, rash and muscle aches, which subside on their own.
c. Like with any other injectable vaccine, there could be mild pain and redness at
the injection site.

MYTH:
Safety and efficacy of these vaccines have not been tested
FACT:
a. Millions of children have been immunized with MR vaccine safely all around
the world.
b. Live attenuated MR vaccines currently in use have an excellent track record
for safety and efficacy.
c. The vaccine being given in the MR campaign is produced in India and is
licensed by Central Drugs Standard Control Organization (India). The same
vaccine is being given in routine immunization programme of India and in many
neighbouring countries like Bangladesh, Sri Lanka, Nepal and Myanmar.

2. Foreign Manufactured Vaccine

MYTH:
MR vaccine has been manufactured outside India and is being tested on
Indian children

FACT:

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 The MR vaccine administered under the current MR campaign is produced
in India and has been licensed by the Central Drugs Standard Control
Organization (India).

Majority of the global measles-rubella (MR)

vaccines supplies are from India)

3. Underserved Community

MYTH:
a. Conspiracy that MR vaccine is being used to control
fertility amongst Muslim population
b. Is it only for the Muslim community and is this a conspiracy
of the national government?

FACT:
a. There is no link between MR vaccine and infertility.

b. The measles-rubella (MR) vaccine provides protection against measles

and rubella diseases and the complications (like disability and untimely
death) associated with the diseases.
c. The MR campaign is being carried out to eliminate measles and control
rubella and congenital rubella syndrome (CRS) in the entire country.
d. The campaign aims to rapidly build immunity in the population and break
the chain of transmission of the diseases. It targets all children, both boys
and girls, in the age group of 9 months to less than 15 years across the
country, irrespective of any religion.

4. Age for Administrating the MR Vaccine

MYTH:

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 Vaccine should be administered during the adolescent stage and not when
children are infants/toddlers

FACT:
a. Administration of measles vaccine during the period when children are most
susceptible, i.e., infancy, is important to ensure optimal protection.
b. WHO recommends that in countries where there is a high risk of measles
mortality among infants, MCV1 should be administered at the age of 9 months.
c. The first dose of MR vaccine needs to be administered after the completion of
9 months until 12 months of age and the second dose at 16–24 months.
d. Under the current MR campaign, every child in the age group of 9 months to
less than 15 years needs to be vaccinated with a supplementary dose,
irrespective of previous vaccination history (whether through campaigns or
routine immunization).

5. Administration of the MR Vaccine

MYTH:

Needles being used during the vaccination campaign are not safe

FACT:
The syringes and needles used under the measles-rubella campaign come in
sterile packing and are auto-disable syringes, which cannot be reused.

6. Child who has already been vaccinated for MR

MYTH:
Pediatricians are advising parents to skip the drive either because the child has
already been vaccinated or because they feel it does not make a significant
impact to child’s health.

FACT:
a. Even those children who have been vaccinated for measles by their
paediatrician or at health centres, should take the MR vaccine during the
campaign.
b. It has been seen that vaccinated children were also getting the diseases,
therefore, the additional dose during the campaign implies additional protection
to the children. Measles is a major childhood killer disease and rubella leads to
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 lifelong birth defects. Both diseases have no cure, but can be prevented by
taking the MR vaccine. It is important for children to take the vaccine both in
routine immunization and in campaigns.

7. Why Government Schools?

MYTH:
General community members raised the questions why the health system has
selected only the government schools and not big private schools for MR
campaign

FACT:
a. MR vaccination campaign will be conducted across all schools irrespective of
whether it is a government or a private school.
b. The MR campaign is being carried out to eliminate measles and control rubella
and congenital rubella syndrome (CRS) in the country, for which all susceptible
children need to be vaccinated to break the chain of the diseases.

MYTH:
It is a government programme, and therefore implemented in government
schools, but why are private schools being made to accept the vaccine?

FACT:
a. The MR campaign is being carried out to eliminate measles and control rubella
and congenital rubella syndrome (CRS) in the country, for which all susceptible
children need to be vaccinated to break the chain of the diseases. The MR
campaign dose is an additional dose, over and above the routine dose.
b. This will be conducted in both public and private schools. All children, both
boys and girls, in the age group of 9 months to less than 15 years need to be
vaccinated in order to knock out the diseases and break the transmission chain.

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3. STANDARD RESPONSE PROTOCOL
When an AEFI gets reported, the media will look for immediate answers (especially in
case of severe AEFIs like hospitalization or death)

 CHALLENGE: AEFI causality assessment takes long and therefore the actual
cause cannot be known immediately.

 SOLUTION: The media should be given IMMEDIATE but LIMITED response.

Mentioned below is the standard response protocol for communication flow during a
crisis or an AEFI:

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 3a. Standard response protocol at district level

Table 1: Communication flow during a media query on AEFI at district level

*Each response mentioned in the table has been elaborated below in the table.

DISTRICT WHO WHEN HOW WHAT

WHAT TO DO

FIRST District Within 6 WRITTEN 1. Respond to media using District media response template.
RESPONDENT Immuniz hours When the reporter calls, if you don’t have all the
information, tell them to wait and call back or mail the
ation of queries and that response will be given.
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 Officer media 2. Notify State EPI Officer/CMO/DM on the event, media
(DIO) query queries and response on phone and email.
(Fill the
media
response WHAT TO SAY
(Phone Before template)
number, the story Give basic details of the AEFI without speculating on the
email id to goes to cause. Convey that case/s have been noted, the investigation
be floated print, is on, kind of investigations conducted and that reporting AEFIs
to the that is do not mean the vaccine has caused it. The AEFI surveillance
media) by 6pm. is very active and closely monitors all cases. Close the
message by stating that vaccinations are safe and the
programme protects against vaccine preventable diseases and
saves lives.

SECOND Chief WHAT TO DO

RESPONDENT Medical
Officer Simultan SPOKEN Notify DIO on media queries and response simultaneously on
(Independent (CMO), eously phone.
source) Chairman with the
, District first
AEFI respons
WHAT TO SAY
committe e
e Demystify AEFIs to media as per queries.

WHAT TO DO

DIO 12-24 STATEME Scan channels and newspapers. Check newspapers/electronic

hours NT media channels for coverage - correct facts used, proper
of (WRITTEN) message given, balanced reporting, not creating panic,
media harming the programme.
query
1. In case of discrepancies in reporting of facts or if panic is
BYTE being created, call the reporter and clarify politely and offer
further support.
Second (can read 2. Do not lose temper and close communication channels
responde out facts or * Second respondents to support DIO, demystify AEFIs and
nt take AEFI surveillance as system strengthening.
support
WHAT TO SAY
from written
statement) Verify facts given earlier. Add updates on new
information/changed situation/progress of investigation.
Do not speculate on cause of AEFI. Reiterate that reporting
AEFIs do not mean the vaccine has caused it. Vaccinations
are safe and the programme protects against vaccine
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 preventable diseases and saves lives. Vaccines are given
during infancy/childhood when morbidity and mortality are
naturally high so this could be a coincidental. However, other
causes are not ruled out until investigations are over.

DIO 48 WHAT TO DO
hours
Second or later Byte/Talk to Keep the media informed about further investigations. In case
responde – if reporters of discrepancies in reporting of facts or if panic is being
nt media created, call the reporter and clarify politely and offer further
reports support. Convey that such reports could harm the immunization
persist programme and put more children at risk of diseases.

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3b. Standard Response Protocol at State Level
Table 2: Communication flow during a media query on AEFI at state level

*Each response mentioned in the table has been elaborated below in the table.

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 STATE WHO WHEN HOW WHAT

WHAT TO DO
FIRST State EPI Within 6 WRITTEN
RESPOND Officer hours of 1. Respond to media using state media response
ENT media (Fill the media template. When the reporter calls, if you don’t have all
(SEPIO)
response the information, tell them to wait and call back or mail
query. the queries and that response will be given.
template)
2. Notify state immunization division on the event, media
Before the queries and response on phone and email.
(Phone story goes to
number, print in the
email id to evening, that WHAT TO SAY
be floated is by 6pm.
to the 1. Give basic details of the AEFI case/s, where it has
occurred, without speculating on the cause. Convey
media)
that case/s have been noted, the investigation is on,
what kind of investigations are conducted and that
reporting AEFIs do not mean the vaccine has caused
it. Give the latest information on investigations
conducted and if a team from the state AEFI
committee has gone to investigate it.
2. Close the message by stating that vaccinations are
safe and the programme protects against vaccine
preventable diseases and saves lives.

WHAT TO DO
SECOND Chairman, Simultaneou SPOKEN
RESPOND State AEFI sly with the Notify SIO on media queries and response simultaneously
ENT committee first response on phone.

(independ
ent
sources) WHAT TO SAY

Demystify AEFIs to media as per queries.

Statement
(written) WHAT TO DO
SEPIO 12-24 hours
1. Notify central Govt. on media queries and response on
if queries phone and email.
persists Byte 2. Scan channels and newspapers. Check
newspapers/electronic media channels for coverage -
(can read out correct facts used, proper message given, balanced
reporting, not creating panic, harming the programme.
facts or take May use help from IEC officer.
support from 3. In case of discrepancies in reporting of facts or if panic
Second is being created, call the reporter and clarify politely
written statement)
respondent and offer further support.
4. Do not lose temper and close communication channels

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 * Second respondents to support DIO, demystify AEFIs
and AEFI surveillance as system strengthening.

WHAT TO SAY

Verify facts given earlier. Add updates on new

information/ changed situation/progress of
investigation. Do not speculate on cause of AEFI.
Reiterate that reporting AEFIs do not mean the vaccine
has caused it. Vaccinations are safe and the programme
protects against vaccine preventable diseases and saves
lives. Vaccines are given during infancy/childhood when
morbidity and mortality are naturally high so this could be a
coincidental. However, other causes are not ruled out until
investigations are over.

SIO
WHAT TO DO
Second 48 hours or Byte/Talk to
respondent later – if reporters 1. Notify central Govt. on media queries and response on
media phone and email.
2. Keep the media informed about further investigations.
reports In case of discrepancies in reporting of facts or if panic
persist is being created, call the reporter and clarify politely
and offer further support. Convey that such reports
could harm the immunization programme and put more
children at risk of diseases.
* Second respondents to support DIO, demystify AEFIs
and AEFI surveillance as system strengthening.

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 4. SAMPLE SCENARIOS AND STANDARD RESPONSES
4a.If there is a possible case of AEFI and the report is out in the
media.
(The media must be given a basic response, as soon as possible so that they don’t
create panic in the community)
RESPONSE: We have taken a note of the recently reported incident and the district
AEFI committee is investigating the matter. The family will receive complete medical
assistance and we are helping them in all ways possible.

4b. If Death Is Confirmed Due to an AEFI and the Report Is

Out in media
(Questions have been raised about the safety of the vaccine and there is a demand
to stop the use of the vaccine.)
RESPONSE: We express our deepest condolences to the family. (Add a few details
of the steps taken and the support provided by the govt. to help the family.) We
are providing all assistance to the family and are investigating the cause of the death.
All records are being examined by the experts who will be able to determine the
exact cause.
The XX vaccine is safe, effective and approved by the World Health Organization for
preventing infection in children. It has been licensed by the Drug Controller General
India after thorough review of the evidence. It is important to note that XX vaccine
has been proven to prevent a large number of deaths and hospitalizations due to YY
(disease).
(We have strengthened the AEFI surveillance to ensure that all cases are reported
and investigated. Our front line workers have been trained to detect/diagnose any
possible case and report it immediately to the ANM and the medical officer. We have
clear cut guidelines on the basic first aid, diagnosis and referral for further
management. Facilities like an ambulance etc. will be provided free of cost like for
any other emergency).

4c. If parents oppose to the MR vaccination in schools

RESPONSE: The Measles-Rubella vaccination aims to offer protection to children

from severe illness and death. Vaccinations are proven to protect the lives of children
and as a public health intervention they should be administered to all children,
irrespective of their previous vaccination history, gender, social background, and/or
their religion.

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 Although the vaccination is voluntary, it is essential in the interest of public health,
especially when the Indian government has set a goal of eliminating measles and
rubella by 2020. Our aim is to ensure that each and every child in the state is
protected against Measles and Rubella.

4d) If anti-vaccine rumors are being circulated (in any form)

discouraging beneficiaries to get their children vaccinated
RESPONSE: Measles is a leading cause of child deaths even though it can be
stopped using a safe and cost-effective vaccine. India accounts for close to one-
third of the world’s 1,34,000 measles annual deaths. Measles vaccination has led
to a 79% drop in measles deaths between 2000 and 2015 worldwide. The vaccine
is safe, effective and approved by the WHO for preventing infection in children.
(Source: WHO)
We are investigating and source and authenticity of the audio-video messages
being circulated on social media and will take necessary strict action against
persons spreading rumors.

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 DRAFT RESPONSES FOR POSSIBLE AEFIs
Regular response for any AEFI that maybe reported

XX DISTRICT, NAME OF THE STATE - DATE - As a part of the Universal Immunization

Program, the Government of Madhya Pradesh vaccinated_______ (number of) children against
vaccine preventable diseases including Polio, childhood TB, Diphtheria, Pertussis, Tetanus,
Hepatitis B, Measles and _________ in the state between the months of __________-
___________. The Government of ________ (specify state) Madhya Pradesh, through its
ongoing efforts, has achieved an immunization coverage rate of _______% in ______ (year).

_______ (number of) doses of BCG/DPT//OPV/Measles/____(others specify) (choose the

vaccine in question) have been administered between (the dates) ______-_______.

As a part of the routine surveillance, _______ (number of) Adverse Effects Following
Immunization (AEFIs) have been reported on _____ (date) in the district/s______(name of
district/s), including _______(details of case/s – e.g. 4 deaths, 3 hospitalizations) in
______(months). The AEFI surveillance system records all minor adverse events (such as
rashes, swelling at the injection site, fever etc) and investigates the serious cases (such as death
and hospitalization) to strengthen the immunization program.

In the recently reported case of _____(DETAILS HERE) complete support and medical
assistance will be provided/is being provided to the family. The district AEFI committee is
investigating the above case/s with support from the state govt. All medical records are being
reviewed/ xx samples have been collected/postmortems are being conducted/_____ (please add
particulars of the relevant investigation/s).

AEFI surveillance is a reporting system to investigate the potential side effects after vaccination.
Reporting an AEFI does not mean the vaccine has caused it. The cause can be determined only
after proper investigation. There are wide ranging reasons for most side effects.

About Immunization:

Vaccination has been recognized as the most effective public health intervention for child health,
preventing disease mortality and morbidity. Every year, _______ (number of) children suffer
from_______ (diseases/specific to antigen in question- depending the available data) in the state.
Manufacturing of vaccines is a tightly monitored process with multiple checks at different stages
of production. Post production, each batch goes through tests to ensure quality and safety before
they are released for use.

(Please remember it is important to sound empathetic to the death of a child in your

responses and avoid sounding mechanical)

Contact Details:

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