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Persistence of susceptibility to measles in France despite routine immunization: a cohort analysis.

P Chauvin and A J Valleron

Institut fédératif Saint-Antoine de Recherches sur la Santé, Paris, France. chauvin@b3e.jussieu.fr

OBJECTIVES: This study examined the impact of French routine programs urging the combined measles-mumps-rubella immunization of 15-month-old children. METHODS: We applied a cohort analysis to surveillance data collected by general practitioners to estimate the cumulative incidence rate per 1000 unvaccinated children and the proportion of susceptible children, by age and for each birth cohort between 1985 and 1995. RESULTS: More than 70% of unvaccinated children born in 1985 and 1986 had measles by the age of 10. This incidence rate dramatically decreased after implementation of the routine measles-mumps-rubella immunization program in 1989, but the proportion of 5-year-olds susceptible to measles has not decreased appreciably. In 1996, more than 15% of the children born between 1990 and 1995 were susceptible. CONCLUSIONS: The measles vaccine coverage achieved by the French routine immunization program remains insufficient as regards reducing the number of susceptible children.