Policy for measles elimination in Canada and program implications.

In Canada, both the National Advisory Committee on Immunization and the Canadian Paediatric Society have recommended a goal of measles elimination. Because immunization services are a responsibility of the provincial government, most provinces maintain advisory bodies to respond more specifically to their needs and to interpret national recommendations within the provincial context. Provincial responses to the measles elimination proposal are reviewed with reference to legislation and to components of the feasibility of the program, such as financial support, levels of staffing, efficacy of vaccine, surveillance, management of records, handling of vaccine, security of supply, type of delivery system, and desirability of a federal financial commitment. Clarification of national recommendations is urged, especially with regard to revaccination of individuals who previously received killed measles vaccine. Progress in provincial programs is reviewed, and a flexible approach is advocated in view of the different epidemiologic circumstances and delivery systems among the provinces. If adopted by all Canadian provinces, the goal of measles elimination within the current decade may be feasible for North America.