Older children should be included

EDITOR, - Do others share my reservations about the national measles and rubella immunisation campaign?1 It is based on a model dear to the hearts of some people who have influence in and around the Joint Committee on Vaccination and Immunisation and draws on campaigns for one off “catch ups” in the Caribbean and in Latin America,2 Such campaigns are not necessarily transferable to Britain.

Previously the Joint Committee on Vaccination and Immunisation stated that there were cohorts of increasing age still susceptible to measles and recommended that they should be offered measles, mumps, and rubella vaccine if they had not had it before.3 It is with these cohorts that the real problem for future years lies (figure). Measles is more severe in older teenagers and young adults, and the American experience of outbreaks in colleges and universities would inevitably be repeated in Britain.4 Health authorities, such as Argyll and Clyde Health Board, that followed those recommendations, however, got no financial help and are now likely to be penalised through having to deal with parents' and health professionals' confusion and frustration over the recommendation that children should be immunised with the measles and rubella vaccine even if they have previously been immunised with measles, mumps, and rubella vaccine.

As the group at risk are principally older pupils, many of whom have not been immunised or had natural measles, it seems perverse to restrict the campaign to those aged 5–10 and not to immunise sixth form students. In Scotland a decision has been taken to include all secondary schoolchildren in the …