Changes

The USA has mandatory vaccination according to an official CDC schedule. Enforcement is left to the states. Most states have medical and religious exemptions. Some states make it very easy to opt out of vaccines, while other states strictly enforce compliance for school attendance. The difference in vaccination rates between these states is actually very slight, and usually not nearly enough to affect herd immunity.  

The USA has mandatory vaccination according to an official CDC schedule. Enforcement is left to the states. Most states have medical and religious exemptions. Some states make it very easy to opt out of vaccines, while other states strictly enforce compliance for school attendance. The difference in vaccination rates between these states is actually very slight, and usually not nearly enough to affect herd immunity.  

As of February 2008, the CDC noted that "fewer than 100 measles cases are now reported annually in the United States and virtually all of those are linked to imported cases" in which someone is infected during overseas travel. The USA maintains herd immunity for measles, even in states where it is easy to opt out of vaccination requirements.<ref> [http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5708a3.htm]</ref> Measles can be serious; according to an article in The Times, "About one in every 15 children has complications that can include [[meningitis]], [[pneumonia]], [[fits]], [[encephalitis]] (swelling of the brain), [[blindness]] and [[brain damage]]."<ref>The Sunday Times, ''How the MMR scare led to the return of measles'', February 8, 2009[http://www.timesonline.co.uk/tol/life_and_style/health/article5683687.ece]</ref> In the England and Wales, there were 1,348 cases of measles in 2008; two children died of the disease. <ref>The Sunday Times, ''MMR doctor Andrew Wakefield fixed data on autism'', by Brian Deer, February 8, 2009 [http://www.timesonline.co.uk/tol/life_and_style/health/article5683671.ece]</ref>

As of February 2008, the CDC noted that "fewer than 100 measles cases are now reported annually in the United States and virtually all of those are linked to imported cases" in which someone is infected during overseas travel. The USA maintains herd immunity for measles, even in states where it is easy to opt out of vaccination requirements.<ref> [http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5708a3.htm]</ref> Measles can be serious; according to an article in The Times, "About one in every 15 children has complications that can include [[meningitis]], [[pneumonia]], [[fits]], [[encephalitis]] (swelling of the brain), [[blindness]] and [[brain damage]]."<ref>The Sunday Times, ''How the MMR scare led to the return of measles'', February 8, 2009[http://www.timesonline.co.uk/tol/life_and_style/health/article5683687.ece]</ref>

The CDC notes that when a measles outbreak occurs, the cost to taxpayers can be substantial. Public health responsibilities include "identification of cases, isolation of patients and vaccination, administration of [[immune globulin]], and voluntary quarantine of contacts who have no evidence of measles immunity...In Iowa, the public health response to one imported measles case cost approximately $150,000."<ref>Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, ''Outbreak of Measles --- San Diego, California, January--February 2008'', February 29, 2008 [http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5708a3.htm]</ref>

The CDC notes that when a measles outbreak occurs, the cost to taxpayers can be substantial. Public health responsibilities include "identification of cases, isolation of patients and vaccination, administration of [[immune globulin]], and voluntary quarantine of contacts who have no evidence of measles immunity...In Iowa, the public health response to one imported measles case cost approximately $150,000."<ref>Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, ''Outbreak of Measles --- San Diego, California, January--February 2008'', February 29, 2008 [http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5708a3.htm]</ref>

===Herd Immunity in Britain===

===Herd Immunity in Britain===

Due to a decrease in vaccination, measles has become endemic in Britain. This means that measles does not need to be brought in by travelers, but instead has a large enough base of unvaccinated individuals for it to continuously spread inside the country. In London, only 71 percent of children receive the first dose of the vaccine and only 51 percent the second dose. Due to this decline, there were 461 cases in Britain in the first half of 2008. These cases have had tragic consequences, with the death of a 17 year old reported in 2008.<ref>[http://www.healthdirect.co.uk/2008/07/measles-endemic-in-britain-official.html Health Direct NHS watch blog]</ref> This immunization failure is due to parents opting out of the MMR vaccine program in the wake of the claims concerning links between the vaccine and autism. <ref>http://www.timesonline.co.uk/tol/news/world/us_and_americas/article4100287.ece</ref>

Due to a decrease in vaccination, measles has become endemic in Britain. This means that measles does not need to be brought in by travelers, but instead has a large enough base of unvaccinated individuals for it to continuously spread inside the country. In London, only 71 percent of children receive the first dose of the vaccine and only 51 percent the second dose. In England and Wales, there were 1,348 cases of measles in 2008; two children died of the disease. <ref>The Sunday Times, ''MMR doctor Andrew Wakefield fixed data on autism'', by Brian Deer, February 8, 2009 [http://www.timesonline.co.uk/tol/life_and_style/health/article5683671.ece]</ref> This immunization failure is due to parents opting out of the MMR vaccine program in the wake of the claims concerning links between the vaccine and autism. <ref>http://www.timesonline.co.uk/tol/news/world/us_and_americas/article4100287.ece</ref>

== Adverse Reactions ==

== Adverse Reactions ==