Declining vaccination rates in the UK mean that measles may re-emerge as an endemic disease there, Science reports (2003;301:804). Researchers say herd immunity is at risk because the vaccination rate in some parts of the country has fallen below 80%. In the Irish Republic, where the vaccination rate has fallen to 72%, 1600 children recently developed measles and 3 died. A 2002 Health Canada survey found that 94.5% of children had at least 1 dose of MMR vaccine by age 2. Last year 7 cases of measles were reported nationally, and 13 have been reported this year. Dr. Varu Ghese, head of surveillance for vaccine preventable diseases at Health Canada, said all the cases were imported. About 745 000 children die annually of measles. It is the leading cause of vaccine-preventable death among children and ranks fifth overall as a cause of death among children under age 5. The Cape Town Measles Declaration, a World Health Organization program announced in October, aims to halve the number of deaths attributable to measles by 2005. The vaccine costs US$0.26 per person. — Barbara Sibbald, CMAJ