On-time delivery of the first dose remains the highest programme priority, but reaching all children with 2 well recorded doses of measles vaccine should be the standard for all national immunization programmes. The second dose can be administered through routine services or given periodically through mass campaigns to defined age groups. Measles elimination requires

Where measles transmission is high, the first dose of measles containing vaccine (MCV1) should be given at 9 months of age, but also to all unvaccinated children over this age. Where transmission is low, MCV1 administration at 12 months of age is preferable.

MCV2 may be added to the routine immunization schedule in countries that regularly achieve > 80% national MCV1 coverage. Countries that do not meet this criterion should rather prioritize improving MCV1 coverage and conducting high quality follow-up campaigns. Where MCV1 is given at 9 months of age, the routine MCV2 should be administered at 15-18 months of age. In countries with very low measles transmission and MCV1 administered at 12 months, the optimal time for routine MCV2 (e.g. between age 15-18 months – school entry) depends on programmatic considerations. In countries with moderate to weak health systems, regular measles immunization campaigns can protect children who do not have access to routine health services.

Measles vaccination should be routinely given to potentially susceptible, asymptomatic HIV-infected children and adults. To limit the impact of measles outbreaks, WHO encourages thorough surveillance and risk assessment and rapid response, including expanded use of vaccination. Careful safety surveillance of possible adverse events must remain a key component of all immunization programmes