[Guidelines for vaccination against measles in children]

After the introduction of massive immunization campaigns in Mexico, started in 1973, the measles mortality rate has been reduced in children under five years of age from 2.8% in 1989 to a level of 1.6% in 1985. Two epidemics occurred in 1985 and 1989 with 19,460 and 20,076 reported cases respectively. In the first quarter of 1990 a total of 22,906 cases were reported. The age distribution has been: patients greater than 1 year 26.3%; 1-4 years 24.8%; 5-14 years 35.5% and greater than 15 years 18.2%. The vaccination coverage, between 1987 and 1988, ranges from 34% to 75% in outbreaks studies and in the National Health Survey. The vaccine efficacy in those outbreaks has been estimated from 63% to 89%. The epidemics have been primary related to low vaccination coverage during the last 15 years. The conglomeration of a cumulative number of non vaccinated persons could explain the distribution of cases in all age groups. The strategy based on two doses as has been recommended in the US, is useful in programs addressed to eradicate measles, but the low resources and limited access to health services in rural communities of Mexico have made these control measures in feasible. The measles control in Mexico, must be based in vaccinate each child at the first anniversary, this strategy could be enough to take off the measles epidemics.