To the Editor.
—The recent article concerning the significant increase in measles cases in the past few years1 discussed the issue very thoroughly and provided many ways that physicians, clinics, health departments, and government agencies can try to improve immunization rates in young children.Certainly, there are deficiencies in our patchwork system of providing immunizations to children in the public and private sectors. However, these deficiencies are not new, and the authors did not question what may have changed in the past few years to cause the rate of measles infection, which was generally less than 5000 cases per year through the 1980s, to jump to more than 18000 cases in 1989 and more than 25000 cases in 1990.I believe that a major change in the last few years, which was not fully discussed in the article, is the cost of the vaccines themselves. The authors quoted the
Nassau RD. The Costs of Preventing Measles. JAMA. 1992;267(5):655–656. doi:10.1001/jama.1992.03480050059023