THE 1990 health objectives for the nation included 18 objectives on immunization.1 This update reports on progress toward achievement of these objectives through 1987.
IMPROVED HEALTH STATUS
The first eight objectives cite the morbidity reduction targeted for eight diseases by 1990.The targets for diphtheria and poliomyelitis appear to have been met, and substantial progress toward the targets for tetanus, rubella, and congenital rubella syndrome has been achieved. Morbidity from mumps had been declining until 1986, when the incidence of mumps increased 161%.2 The 12,848 cases reported in 1987 are the most since 1979. This increase largely reflected outbreaks in high schools and colleges and probably resulted from the absence or lack of enforcement of school immunization requirements in some states.2-4 Illinois and Tennessee had the highest mumps incidence rates in 1986 and 1987; these two states began