Historical evidence shows that the measles vaccine is effective. As uptake of the vaccine has increased since the introduction of the first vaccine in 1968, the incidence of measles has fallen correspondingly. During the 1990s when uptake of the measles, mumps, and rubella vaccine (MMR) exceeded 90%, the incidence of measles and subsequent mortality was very low.

• Before the first measles vaccine was introduced, annual notifications of the disease varied between 160,000 and 800,000 with peaks every 2 years. Uptake was slow, however, and measles incidence only fell to 50,000–80,000 until the late 1980s, when uptake increased following the introduction of MMR and led to a large reduction in cases.
• The two-dose MMR regimen was implemented in 1996 to ensure that children were adequately immunized against measles. This followed a successful previous catch-up campaign with measles-rubella (MR) to cover older children (who were susceptible because they had missed out on MMR), and which had led to a seven-fold reduction in cases.
• Today measles is very rare in the UK, but there are fears that decreased uptake could result in epidemics as herd immunity fails. There have already been small outbreaks in some areas, leading to the death of an immunocompromised child in 2006 (immunocompromised children rely on herd immunity for protection as they are unable to respond to the vaccine themselves).

[DH, 2006j]