Sir.—In 1984, at the time of a measles outbreak among students at Dartmouth College, Hanover, NH, an audit of 4,903 student health records revealed that 59.6% lacked adequate documentation of measles immunity. The overall attack rate among the students was 0.7% (varying from 3.2% to 0.6%) during the outbreak, yet an extensive vaccination program was carried out at a cost of over $30,000. A similar outbreak program at Indiana University, Bloomington, exceeded $225,000.1
At the present time, proof of prior inoculation with measles, mumps, or rubella vaccines in the United States is placed primarily on the individual, parent(s), or guardian. The need for documentation is compounded by the large numbers of children required by law in many states to show proof of prior inoculations at the time of school entry. Too often this information is not available within the time requested by health care providers or school authorities,
WILKINS J. On-line Documentation of Measles-Mumps-Rubella Vaccine Inoculation. Am J Dis Child. 1985;139(10):961. doi:10.1001/archpedi.1985.02140120007001
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