Immunization, Vaccines and Biologicals

SAGE Working Group on rubella vaccines (March 2010 to July 2011)

Terms of Reference

The Working Group will be asked to propose necessary updating of WHO recommended vaccination strategies (as stated in the 2000 rubella vaccine position paper) for use of rubella vaccines according to the disease control goal for rubella and congenital rubella syndrome (CRS).

Further, the Working Group will identify information gaps, guide the work required to address the information gaps, and review the evidence in preparation for a SAGE review of the updated vaccination strategies.

The specific questions to be addressed:

  • What are the possible goals for CRS and rubella control and what are the most appropriate vaccination strategies to achieve these goals?
  • What is the minimum required immunization coverage that should be achieved and maintained to ensure that the introduction of a rubella containing vaccine does not increase the risk of CRS?

The approach to address these questions may include:

  • Review the burden of CRS according to country development status
  • Review country experience with introduction and use of rubella vaccines (in countries with information that allows a robust analysis)
  • Mathematical modelling to explore different scenarios (model needs to be fully dynamic given the characteristics of rubella and the impact of the vaccine on disease)
  • Cost-effectiveness analysis of different approaches, in particular in low and low-middle income countries (as per WHO guidelines)


SAGE Members

  • Helen Rees, Chair
  • Jon Abramson
  • Hyam Bashour (until April 2011)
  • Malik Peiris
  • Oyewale Tomori


  • Susan Reef, Centres for Disease Control, USA
  • Kari Johansen, European Centre for Disease Prevention and Control, Sweden
  • Karen Lewis-Bell, Ministry of Health, Jamaica
  • Aiqiang Xu, Shandong Center for Disease Control and Prevention, China
  • Emilia Vynnycky, Health Protection Agency, UK
  • Liliane Grangeot-Keros, Antoine Béclère Hospital, France

WHO Secretariat

  • Peter Strebel
  • Alya Dabbagh


All members completed a declaration of interest. Only two members reported any interests. It was concluded that all members could take part in full in all of the discussions. The reported relevant interests are summarized below:

Liliane Grangeot-Keros
  • Her hospital received small grants from Roche, Beckman, BioMerieux, Abbott, DiaSorin, Siemens and Biorad for evaluation of rubella diagnostic kits. She received small consultancy fees as part of the contract. These interests were assessed as personal, specific and financially insignificant*.
Malik Peiris
  • His research unit received during 2007-2010 funding from Crucell, Combinatorx, DIVA Solutions, Baxter and GlaxoSmithKline to conduct research in influenza viruses and vaccines. These interests were assessed as non-personal, non-specific and financially significant*.
  • Received in 2009 consultancy fees from GlaxoSmithKline in pandemic preparedness. This interest was assessed as personal, non-specific and financially insignificant*.
  • Received in 2009 travel grant from GlaxoSmithKline to attend the 3rd Vaccine Global Congress. This interest was assessed as personal, non-specific and financially insignificant*.

* According to WHO's Guidelines for Declaration of Interests (WHO expert), an interest is considered "personal" if it generates financial or non-financial gain to the expert, such as consulting income or a patent. "Specificity" states whether the declared interest is a subject matter of the meeting or work to be undertaken. An interest has "financial significance" if the honoraria, consultancy fee or other received funding, including those received by expert's organization, from any single vaccine manufacturer or other vaccine-related company exceeds 10,000 USD in a calendar year. Likewise, a shareholding in any one vaccine manufacturer or other vaccine-related company in excess of 1,000 USD would also constitute a “significant shareholding”.

Last updated: 22 August 2011