Measles control indeveloping anddeveloped countries: thecaseforatwo-dose policy

Despite majorreductions intheincidence ofmeaslesanditscomplications, measlescontrol witha single doseofthecurrently usedSchwarz strain vaccine hasfailed toeradicate thedisease inthe developed countries. Indeveloping countries anenormoustoll ofmeasles deaths anddisability continues,despite considerable efforts andincreasing immunization coverage. Empirical evidence from anumberofcountries suggests thata two-dose measles vaccination programme, byimproving individualprotection andherdimmunity canmakeamajorcontribution tomeasles control andelimination of local circulation ofthedisease. Cost-benefit analysis alsosupports thetwo-dose schedule intermsof savings inhealth costs, andtotal coststosociety. A two-dose measles vaccination programme istherefore anessential component ofpreventive health careindeveloping, aswell asdeveloped countries for the1990s.

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