Large outbreak of measles in London: reversal of health inequalities

Reported rates of MMR vaccine uptake in London at 2 years of age fell from the mid-1990s to 73% in late 2001 compared to 84% for England as a whole.1 Nationally, coverage decreased by a greater proportion in affluent compared to deprived areas.2 Mathematical modelling has predicted this drop would be sufficient to sustain measles transmission in nine health authorities in England and Wales, seven of them in London.3 However, substantial measles outbreaks remained rare in London from 1996 to mid-2001, occurring primarily as small clusters in religious and other communities opposed to vaccination. The largest outbreak consisted of 43 confirmed cases in east London in early 2001.4 In late December 2001 a cluster of confirmed measles cases was reported among preschool children in south London, the start of the …