Measles outbreak in Fife: which MMR policy?

The introduction of measles, mumps and rubella vaccine (MMR) into the United Kingdom childhood immunisation schedule has resulted in a substantial reduction in the incidence of all three diseases. None the less, there have recently been outbreaks of measles in parts of the country which have a record of high MMR uptake among young children. In these outbreaks it is mainly older children who have been affected. This report documents such an outbreak in Fife, an area with a very high MMR uptake among two-year-old children (96%). The current policy of giving MMR vaccine only once to children at 15 months of age may not be sufficient to enable the United Kingdom to achieve the WHO target of measles elimination by the year 2000. Other possible strategies to achieve this objective are discussed.