In the years 2002-2003 a large measles outbreak occurred in Italy with over 100,000 estimated cases among children below 15 years of age [7] . Following the outbreak, in November 2003, all 21 Italian regions signed an agreement with the Italian Ministry of Health to implement the "National Plan for the Elimination of Measles and Congenital Rubella" [8] . Strategies include among others, improving routine MMR coverage among children below 2 years of age, implementing supplementary vaccination activities for older children and adolescents (aged 6-13 years) and strengthening disease surveillance. Following implementation of the elimination plan, national vaccination coverage for first MMR dose in children at two years of age increased from 82.0% in 2003, to 89.6% in 2007. During the same period of time, incidence of measles in Italy decreased from 22.6/100,000 to <1/100,000 [4, 9] .