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A new look at measles
L M Adcock1, J D Bissey, R D Feigin
1Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
Abstract:
Since the measles vaccine was licensed in the United States in 1963, the number of measles cases has declined by 98%. Nevertheless, measles has not been eliminated as had been hoped, and, in fact, has started to increase in incidence. The increase in the number of cases has been accompanied by a change in measles epidemiology; the highest attack rate now occurs in preschool-age children and in older school-age and college students. The latter is the basis for the adoption of a two-dose measles immunization schedule by the ACIP and AAP. In preschool-age children, however, the problem is more disturbing and reflects low rates of immunization, particularly among inner-city populations. A major public health effort must be directed to achieve and maintain high vaccination rates if measles elimination is to be accomplished. Otherwise, measles outbreaks, with their accompanying morbidity and mortality, will continue to occur.
Insights
Despite a 98% decline in measles cases since 1963, outbreaks are increasing, particularly in young children due to low vaccination rates. Achieving high measles vaccination coverage is crucial for disease elimination.
Area of Science:
- Public Health
- Epidemiology
- Immunization
Background:
- Measles cases have decreased by 98% since the vaccine's introduction in 1963.
- Despite vaccination efforts, measles has not been eliminated and is increasing in incidence.
- Measles epidemiology has shifted, with higher attack rates in preschool-aged children and students.
Framework:
- The Advisory Committee on Immunization Practices (ACIP) and the American Academy of Pediatrics (AAP) recommend a two-dose measles immunization schedule.
- This schedule addresses the rise in cases among school-aged and college students.
- However, low immunization rates in preschool-aged children, especially in inner-city areas, remain a significant concern.
Implementation:
- Targeted public health initiatives are necessary to increase vaccination rates.
- Focusing on inner-city populations is critical to address immunization disparities.
- Sustained efforts are required to achieve and maintain high vaccination coverage.
Implications:
- Failure to improve vaccination rates will result in continued measles outbreaks.
- Outbreaks lead to significant morbidity and mortality.
- Achieving high vaccination coverage is essential for measles elimination.