Measles vaccine — one versus two doses: why and when

  • J. Thipphawong
  • R. Wittes
  • O. Van-Ham


The decision to choose a two-dose measles vaccination schedule depends on whether elimination rather then control is the goal. Both mathematical models and epidemiologic observations suggest that elimination is not possible with only one dose of current measles vaccines. A two-dose schedule is clearly a minimum requirement for elimination. The decision to implement a second dose requires social and governmental acceptance of the need for elimination. The country must have both the desire to commit economic resources and the health care infrastructure to deliver the second dose. Decision makers must realize that it may require ten or more years to achieve elimination. A two-dose schedule will not prevent outbreaks, unless programs are in place to ensure high coverage with both doses. Poorly implemented programs will result in continued outbreaks and loss of public confidence in the strategy. It may be better to identify and vaccinate high-risk groups and thus ensure high first-dose coverage at an appropriate age, rather than to give 90% of the population two doses and 10% of the population no doses.


Vaccine Coverage Maternal Antibody Measle Vaccine Vaccination Schedule Measle Vaccination 
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© Springer-Verlag/Wien 1993

Authors and Affiliations

  • J. Thipphawong
    • 1
  • R. Wittes
    • 1
  • O. Van-Ham
    • 1
  1. 1.Connaught Laboratories LimitedWillowdaleCanada

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