Immunization, Vaccines and Biologicals

Rubella

Transmitted in airborne droplets when infected people sneeze or cough, rubella is an acute, usually mild viral disease traditionally affecting susceptible children and young adults worldwide. Rubella infection just before conception and in early pregnancy may result in miscarriage, foetal death or congenital defects known as congenital rubella syndrome (CRS). The highest risk of CRS is found in countries with high rates of susceptibility to rubella among women of childbearing age.

In 1996, an estimated 22 000 babies were born with CRS in Africa, an estimated 46 000 in South-East Asia and close to 13 000 in the Western Pacific. Very few countries in these regions had introduced rubella-containing vaccine by the year 2008, and therefore the current burden of CRS in these settings is thought to be similar to that estimated for 1996.

Rubella vaccines are available either in monovalent formulation or in combinations with other vaccine viruses, as rubella-containing vaccines (RCVs). Commonly used RCVs are combinations with vaccines against measles (MR), measles and mumps (MMR), or measles, mumps and varicella (MMRV).

Large-scale rubella vaccination during the last decade has drastically reduced or practically eliminated rubella and CRS in many developed and in some developing countries. Indeed, the western hemisphere and several European countries have eliminated rubella and CRS.

WHO recommends that countries take the opportunity of accelerated measles control and elimination activities to introduce rubella-containing vaccines. All countries that have not yet introduced rubella vaccine, and are providing two doses of measles vaccine using routine immunization and/or supplementary immunization activities should consider the inclusion of RCV in their immunization programme.

WHO position papers

Related links

Last updated: 24 April 2012

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