MMWR. Morbidity and mortality weekly report

Since measles vaccine was introduced in the United States in 1963, the reported incidence of measles has decreased 99%, and indigenous measles transmission has been eliminated from most of the country. However, the goal to eliminate measles by October 1982 has not been met. Between 1981 and 1987, a low of 1497 (1983) to a high of 6282 (1986) cases were reported annually (7). Two major types of outbreaks have occurred recently in the United States: those among unvaccinated preschool-aged children, including children younger than the recommended age for routine vaccination (i.e., 15 months), and those among vaccinated school-aged children (2). Large outbreaks among unvaccinated preschoolaged children have occurred in several inner-city areas. In these outbreaks, up to 88% of cases in vaccine-eligible children 16 months to 4 years of age were unvaccinated; as many as 40% of all cases occurred in children <16 months of age. Surveys of immunization levels in areas where these outbreaks occurred indicate that only 49%-65% of 2-year-olds had received measles vaccine (3).

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Advisory Committee on Immunization Practices (ACIP)
Guidelines and Recommendations
Morbidity and Mortality Weekly Report (MMWR)