With a worldwide annual incidence of 31 million cases resulting in 614,000 fatalities in 2002, measles is a main cause of childhood death which could be prevented by vaccination. Since the introduction of immunization with attenuated measles virus vaccine, which led to a decrease in measles cases with a low incidence of 0.2/100,000 inhabitants in Germany in 2004, the population's awareness of the risks of measles has faded. Instead public interest has increasingly focussed on the possible but mostly harmless complications of vaccination. There is concern that the number of those not immunized will increase to such an extent that endemic outbreaks of measles will again occur.