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Thomas L. Schlenker, MD
Milwaukee (Wis) Health Department

JAMA. 1992;268(6):789-790.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.

—From the prevaccine era, there are excellent studies by Hedrich that show how measles outbreaks parallel the number of susceptible children in Baltimore, Md.¹ Dr Lanphear does a very nice job representing how the actual number of susceptible children in Milwaukee increased overtime, even while the overall immunization coverage rates remained the same. Clearly, the correlation between the number of susceptible children and the risk of sustained outbreaks is a strong one and one that could be a useful predictor if there was any practical way to determine the number of susceptible children in time to respond. Unfortunately, at this point, there isn't.

Our data were derived from a retrospective school-based study of kindergarten records and, therefore, was a minimum of 3 years old. United States cities are in dire need of comprehensive computerized immunization databases that can perform real-time assessments of local coverage so that immunization . . . [Full Text PDF of this Article]

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