Measles control in Israel: a decade of the two-dose policy

The introduction of routine measles immunization in Israel in 1967 was followed by a 95% reduction in reported measles incidence. In 1990, a second measles immunization dose was instituted, and up until the end of 1999, 16 birth cohorts were offered the second dose. We present here changes in reported measles incidence in Israel following institution of the two-dose policy.

First-dose coverage is 94%, and coverage for the second school-based dose exceeds 95%. A further 90% reduction in measles incidence has been observed and, following a modest national outbreak in 1994, measles incidence for 1995-99 stands at less than 3/100,000/year.

Since measles is highly contagious, very high immunization coverage rates will be required to preserve these accomplishments, and measles elimination is still years away, but there is tentative evidence that measles containment is at hand. Even greater measles control can be anticipated as vaccine immunogenicity improves and successive cohorts of children come under the 2-dose regimen.