Sir.—The article "A Benefit-Cost Analysis of Mumps Vaccine" by Koplan and Preblud (Journal 1982;136:362-364) on mumps immunization requires some elaboration.
It should be stressed that their careful benefit-cost analysis was based on the use of mumps vaccine in combination with measles and rubella vaccines during the course of a routine health visit at 1 year of age. While this is in keeping with current recommendations, it does not address another aspect of the mumps vaccine program: recall of unimmunized children beyond infancy. We believe that Koplan and Preblud's analysis can be expanded to demonstrate the folly of such programs.
Specifically, the state of New York now mandates exclusion from school of any child who does not have evidence of immunization against a number of diseases, including mumps. School nurses review the immunization records of all pupils and contact physician offices or parents to clarify immunization status. Parents of children who