Abstract
In the Netherlands there has been nationwide vaccination against the measles since 1976. However, in small clustered communities of orthodox Protestants there is widespread refusal of the vaccine. After 1976, three large outbreaks with about 3000 reported cases of the measles have occurred among these orthodox Protestants. The outbreaks appear to occur about every twelve years. We show how a simple Kermack-McKendrick-like model can quantitatively account for the periodic outbreaks. Approximate analytic formulae to connect the period, size, and outbreak duration are derived. With an enhanced model we take the latency period in account. We also expand the model to follow how different age groups are affected. Like other researchers using other methods, we conclude that large scale underreporting of the disease must occur.
Highlights
Upon hearing that vaccination against the measles is nowadays common in the entire developed world and in many developing countries, many people of the 50-andolder generation react with a statement like “Why? It’s just the measles . . . ”
Until vaccination programs became common around 1970, almost every child would get the measles and, in Western countries, 99% recovered without lasting consequences
In September 2010, the 53 member states of the WHO (World Health Organization) European Region agreed to commit to the ambitious goal to eliminate measles in Europe by 2015 [3]
Summary
Upon hearing that vaccination against the measles is nowadays common in the entire developed world and in many developing countries, many people of the 50-andolder generation react with a statement like “Why? It’s just the measles . . . ”. Accounting for the vaccination coverage, the fact that the last major measles outbreak among orthodox Protestants was more than 12 years ago and assuming that on average 5% of pupils enrolled at orthodox Protestant primary schools comprise vaccinated children from outside the orthodox Protestant community, we can estimate that the population of susceptibles at the primary school level comprises about 15 000 pupils. Further assuming that these 15 000 pupils are distributed over all 8 grades, we infer that annually 1900 leave the population and 1900 new susceptible pupils enter.
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