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Authors' reply

BMJ 1994; 309 doi: (Published 09 July 1994) Cite this as: BMJ 1994;309:127
  1. Richard Reading,
  2. Stephen Jarvis,
  3. Allan Colver,
  4. Stan Openshaw
  1. Consultant community paediatrician Norfolk and Norwich Hospital, Norwich NR1 3SR Donald Court professor of community child health Medical School, University of Newcastle, Newcastle upon Tyne NE2 4HH Consultant community paediatrician Beaconhill Children's Centre, Cramlington, Northumberland NE23 8EH Professor of human geography School of Geography, University of Leeds, Leeds LS2 9TJ.

    EDITOR,—Our study did not look at whether things had improved but at whether inequalities had narrowed or widened. From a clinical point of view, protection from infection depends on an interplay between an individual's immunisation status and herd immunity, which for children may vary between the home, school, and neighbourhood. Not until coverage is over 90% in all potential “herds” do variations in coverage stop being important. At lower levels the odds of being immunised are a good proxy measure for the …

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