Evaluating measles control measures and the transition of surveillance strategies in tribal-dominated areas of western India

Measles remains a significant public health challenge despite vaccine availability. This study examines various strategies implemented for measles control and their subsequent impact on the incidence of measles cases in the tribal-dominated districts of Western India. An observational retrospective study was conducted using descriptive statistics and Pearson’s correlation analysis to examine routine, special mass vaccination campaign and supplementary vaccination strategies from 2011 to 2024, and their impact on epidemiological changes. During the Measles-containing vaccines (MCV) era (2011–2017), first-dose coverage (MCV-1) remained high at an average of 97.3%, exceeding the WHO target. However, the second-dose coverage (MCV-2) averaged only 67.7% despite peaking at 86.6% in 2015. After measles–rubella (MR) vaccine introduction in 2018, the average MR-1 coverage was 92.9%, while MR-2 coverage improved significantly to 88.7%, a 21-percentage point gain over previous second-dose levels. Supplementary immunization activities (SIAs) under Mission Indradhanush reached < 1% of the target population but were useful in closing small immunity gaps. The 2017–2018 MR campaign vaccinated 0.114 million children across rural, urban, and semi-urban areas with an Adverse Events Following Immunization (AEFI) rate of only 0.01%. Surveillance shifted from outbreak-based reporting (35 to 291 cases annually) to case-based laboratory-confirmed surveillance, limiting the number of confirmed cases to 0–7 per year between 2018 and 2024. Discard rates stabilized at ~ 3.7 per 100,000. An inverse correlation between MR coverage and incidence (r = − 0.297 for MR-1; r = − 0.209 for MR-2) confirmed the impact of two-dose coverage. High routine coverage, targeted campaigns, and enhanced surveillance are critical to achieve measles elimination, particularly in underserved populations.