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Vaccine. 2014 Feb 26;32(10):1147-52. doi: 10.1016/j.vaccine.2014.01.002. Epub 2014 Jan 15.

Increased measles-mumps-rubella (MMR) vaccine uptake in the context of a targeted immunisation campaign during a measles outbreak in a vaccine-reluctant community in England.

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  • 1Health Protection Agency, London and South East Regional Epidemiology Units, 151 Buckingham Palace Road, London SW1W 9SZ, England, UK; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Control and Prevention, Tomtebodavägen 11A, 171 65 Solna, Stockholm, Sweden. Electronic address:
  • 2Health Protection Agency, London and South East Regional Epidemiology Units, 151 Buckingham Palace Road, London SW1W 9SZ, England, UK.
  • 3Health Protection Agency, Immunisation Department, Colindale, 61 Colindale Avenue, NW9 5EQ London, Greater London, UK.
  • 4Surrey and Sussex Health Protection Unit, Chart Way, Horsham, West Sussex RH12 1XA, UK.



Following a measles outbreak in a vaccine-rejecting community between April and September 2011 in South-East England, local health agencies implemented a two-pronged measles-mumps-rubella (MMR) immunisation campaign from August to October offered at the local general practice where most cases were registered. The campaign included (a) accelerated vaccination of children earlier than scheduled (1st dose at 6-11 months, or 2nd dose at 18-39 months), (b) catch-up of those aged over 18 months who had had no MMR immunisations or were late for second MMR. We investigated the impact of the outbreak and campaign on the number of MMR doses given.


In January 2012, we collected information on MMR vaccination for children registered at the practice aged 6 months-16 years on 1 August 2011, through the child health information system. We counted the number of MMR doses administered in 2011 and compared it to 2008-2010 data. We estimated the proportion vaccinated among the children eligible for the accelerated and catch-up campaign.


The local practice administered 257 MMR doses in 2011, a 114% increase on the average for 2008-2010. Among children eligible for earlier MMR vaccination 5/26 (19%) received a first dose, and 34/57 (60%) a second dose. Among children eligible for catch-up, 20/329 (6%) received their first MMR and 39/121 (32%) their second. Of 1538 children, the proportion completely unimmunised for MMR declined by 3 percentage-points after the outbreak.


Uptake of MMR vaccination significantly increased during the outbreak following the immunisation campaign. Those amenable to MMR vaccination seem to have benefited from the campaign more than those with no previous vaccinations. Future evaluations should address what made a few parents change their mind and have their children vaccinated for the first time during the outbreak.

Copyright © 2014 Elsevier Ltd. All rights reserved.


MMR (measles–mumps–rubella); Measles; Outbreak; Uptake; Vaccination; Vaccination refusal

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