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Vincent Iannelli, M.D.

Vaccination in France - Measles Spotlight

By July 2, 2011

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Even as we talk a lot about the measles outbreaks in the United States, they are really minimal when you compare them to the number of cases in some other countries. And we are not talking about third world countries where high rates of measles continue to make measles one of the leading causes of death in children.

Take France for example.

There have been over 12,500 cases of measles and at least 6 deaths this year in France, with 444 cases of severe pneumonia and 14 cases of encephalitis. There have been at least 20,000 cases of measles in France since January 1, 1998.

In comparison, there have been just over 150 cases in the United States this year and about 369 cases since 2008.

Why do they have so many cases of measles in France? An article in le Parisien, a daily French newspaper, states that "only 40% of children aged 2 years received two doses of vaccine needed for vaccination. We are far from the goal of 95% coverage," and that "young adults are not vaccinated."

These factors created an almost perfect storm for a large measles outbreak, including that:

  • France didn't start giving a booster dose of MMR until 1996, well after the booster was started in the United States (1985), which means that many older teens and younger adults aren't fully protected, since they have likely received only one dose of measles vaccine
  • France has historically had low measles vaccination coverage, as low as 80% since the 1990's, which has made experts consider France as having a low level of control against measles in Europe. Although up to 93% of kids may get a single dose before they start kindergarten now, only about 44% get two doses.
  • vaccine coverage for the MMR vaccine is under 70 to 80% in many southern districts of France

Why does it matter what happens in France? In addition to the fact that the measles cases in the United States are imported from countries like France, the situation in France is a good reminder of what happens when immunization rates drop, even just a little. An increased rate of vaccination exemptions and parents refusing vaccines in the U.S. could easily get us to vaccination coverage levels seen in France and the same types of measles outbreaks.

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July 2, 2011 at 4:53 pm
(1) Paddy says:

I’ve been watching the measles outbreak in France with some interest (e.g. here http://www.invs.sante.fr/Dossiers-thematiques/Maladies-infectieuses/Maladies-a-prevention-vaccinale/Rougeole/Actualites2/Epidemie-de-rougeole-en-France.-Actualisation-des-donnees-au-24-juin-2011), but had no idea the vaccination rates had been as low as that – it explains quite a lot. Thank you!

July 2, 2011 at 6:05 pm
(2) Vincent Iannelli, MD says:

The outbreak in France isn’t easy to follow, as many of the reports that are in English are few and far between. The next report from the European CDC won’t be for another few weeks.

A comment on another post that said the the French had some of the highest vaccination rates in Europe prompted me to dig a little deeper though, since I knew that wasn’t true.

July 4, 2011 at 4:00 am
(3) Gary says:

Looks like the situation in Europe could get worse before it gets better. The European CDC is worried about young people attending large public gatherings during the summer months


So much for plans to eradicate measles in Europe…

November 22, 2011 at 3:26 am
(4) NonVax says:

Looks like all of you need to do some real research.

March 2, 2014 at 12:55 pm
(5) Ravi Wells says:

yes – do some research all of you and see why measles should be a childhood disease where the child obtains LIFELONG immunity by exposure.

and BTW – herd THEORY calls for about 65% – and it is a theory, not proven –

what you say -??

no it is not.

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