Special ArticleThe Role of Measles Elimination in Development of a National Immunization ProgramOrenstein, Walter A. MD Author Information From the Department of Medicine and Pediatrics, Emory University School of Medicine, Atlanta, GA. Accepted for publication September 13, 2006. Address for correspondence: Walter A. Orenstein, MD, Emory Vaccine Center, Room 446, Dental Building, 1462 Clifton Rd, NE, Atlanta, GA 30322. E-mail: [email protected]. The Pediatric Infectious Disease Journal: December 2006 - Volume 25 - Issue 12 - p 1093-1101 doi: 10.1097/01.inf.0000246840.13477.28 Buy Metrics Abstract The U.S. Immunization Program has been one of the most successful efforts in preventive medicine. Since its beginning with passage of the Vaccination Assistance Act in 1962, polio, measles and rubella have been eliminated and many other vaccine-preventable diseases are at record or near record lows. In 1966, 3 years after licensure of the first measles vaccines, the Centers for Disease Control and Prevention began an effort to eliminate measles within the United States, an on-and-off effort that was to last more than 30 years. With measles elimination as the primary driver, fundamental components of today’s immunization program were built that affected not only measles, but all of the vaccines and vaccine-preventable diseases of childhood. Some of the major contributions were the enactment and enforcement of immunization requirements for school attendance in all 50 states, enactment of an entitlement program for vaccine purchase, the Vaccines for Children Program, support for health services research to determine reasons for nonimmunization and interventions to improve coverage, development of standards for immunization practices and the measurement system for immunization coverage in all 50 states and 28 major urban areas. Key lessons have been: (1) the program must rest on a sound base of vaccine science and health services science; (2) having a limited number of measurable goals allows program focus, but consider strategies that have crosscutting impact; (3) accountability is critical to program performance at all levels—state, local and individual practice; and (4) establishing and maintaining political support is essential. © 2006 Lippincott Williams & Wilkins, Inc.