Measles Control in the United States: Problems of the Past and Challenges for the Future

It is useful to review what has happened since the licensing of measles vaccine in 1963, both to assess the progress in eliminating the disease and to identify what remains to be done. Before the introduction of the measles vaccine in 1963, 400,000 to 500,000 cases were reported and an estimated 5 million cases of measles occurred in the United States annually (Fig. 1). By 1979, 16 years after the introduction of the measles vaccine, the incidence of measles had declined 93% (75). At that time, the federal government initiated a campaign to eliminate indigenous measles from the United States by 1982. The strategy consisted of achieving and maintaining high coverage with a single dose of measles vaccine at 15 months of age, careful surveillance by public health departments, and aggressive outbreak control. In addition, during the 1970s, all states passed laws mandating documentation of immunization against measles and other childhood diseases for entry into school.