In the pre-vaccine era, measles was ubiquitous. In the UK, there were 160,000 to 800,000 cases reported every year, with peaks every 2 years.[2] In the US, epidemics also occurred about every 2 to 5 years; 200,000 to 400,000 cases were reported yearly but, in fact, nearly every child in each birth cohort of about 4 million was affected. Highest attack rates occurred in children aged 5 to 9 years, with no difference noted in incidence between males and females.[3] Measles vaccine was introduced in the 1960s, leading to a more than 99% reduction in the number of reported measles cases. Two doses of the measles vaccine are recommended to ensure immunity.[4] In Finland the 2-dose MMR vaccination has been in use since 1982, with high coverage consistently achieved. Indigenous measles has been eliminated since 1994.[5] Since 1994, most measles infections in the US were imported or linked to imported cases.[3] In 2000, measles was declared no longer endemic in the US.

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