Reconstruction of measles dynamics in a vaccinated population

The evaluation of measles vaccination programmes has been problematic because the change in actual numbers of infections and susceptibles over time cannot be directly observed. In this paper, we present a method for estimating the time series of number of susceptibles and infections, as well as the critical vaccination coverage in a vaccinated population. The proposed method is applied to data on measles outbreaks in The Netherlands. We show that the results are self-consistent and in line with available independent estimates. A potential application of the proposed method lies in detecting the loss of herd immunity and assessing the risk of major outbreaks in vaccinated populations.