Measles immunisation compliance: poor impact of bicentennial measles control campaigns on children under five.

A measles immunisation survey was conducted among children who enrolled in school kindergarten classes in the Eastern Sydney Area in 1989. Its aims were to determine baseline compliance rates, to identify subpopulations at risk of poor compliance and to evaluate the impact of the bicentennial measles control campaigns on compliance among children under five years. All 73 schools participated, questionnaires were returned by 2230 (81.4%) children, and compliance with immunisation was 91.3%. 89.1% of children attending public schools were immunised, compared to 91.9% of Catholic school pupils and 95.8% of independent school pupils (chi 2 = 21.4, P less than 0.001). Among public school children, 91.6% of pupils from English-speaking families were immunised in comparison to 81.4% of pupils from non-English-speaking backgrounds (chi 2 = 20.5, P less than or equal to 0.001). The fraction of previously unimmunised children who were known to have been immunised during each year of the measles control campaigns was 16% in 1986-87, 10% in 1987-88 and 9% in 1988-89. These small increments in immunisation uptake suggest that under-five-year-olds were not effectively targeted by the measles control campaigns. However, no control group was evaluated. Immunisation delivery systems must be designed which ensure that all children receive measles-mumps-rubella vaccine as soon as possible after the first birthday. Immunisation promotions and service providers will need to target specific language and socioeconomic groups.