Current Strategy for Urban Measles Control: An Evaluation

Reported measles attack rates are substantially less since licensure of vaccine. Nevertheless, measles continues to be an important cause of morbidity among inner-city populations. In an urban epidemic that occurred after vaccine licensure, the deaths, encephalitis cases, and complication rates among hospitalized patients were similar to those in a prevaccine epidemic. In the earlier and later epidemics, respectively, 23.2% and 30.1% of hospitalized patients were less than 1 year old. In the later epidemic, attack rates were much greater in lower socioeconomic areas than in higher ones. Vaccine failure did not contribute greatly to the later epidemic. Childhood measles vaccination should be given high priority. As long as measles risk remains high, vaccination appears indicated for infants 6 to 9 months old from crowded, lower-income urban areas. These infants will need booster doses later to ensure immunity.