Interruption of measles transmission in Gipuzkoa (Basque Country), Spain

Measles vaccine was introduced in Gipuzkoa (Basque country, Spain) in 1978 and was replaced by the measles, mumps, and rubella (MMR) vaccine for children aged 12-15 months in 1981. A second dose of the MMR vaccine was introduced in 1992. Both doses of the MMR vaccine were well accepted by the population and high coverage was achieved (95% and 91% for the first and second doses respectively for the period 1993-2002). Measles virus circulation was interrupted in the second half of the 1990s: no cases of indigenous measles were notified between 1998 and 2003, and only imported cases have been confirmed during this period. These data indicate that the measles vaccination programme implemented has been effective. Nevertheless, to avoid measles outbreaks following viral introduction, high MMR vaccine coverage levels for the two doses have to be maintained (>95%).