The 1964-1965 rubella pandemic resulted in approximately 20,000 malformed infants and 30,000 stillbirths in the United States, with an estimated economic impact of approximately $1.5 billion.1 The opportunity to prevent similar tragedies was provided when rubella vaccine was licensed in 1969.
Initial control efforts in the United States were aimed at preschool and young school-aged children to decrease the overall number of rubella cases and, consequently, the chances of exposing a susceptible pregnant female. Vaccination of susceptible postpubertal females was given lower priority. Implementation of this strategy has resulted in an interruption of the characteristic epidemics of rubella at six- to nine-year intervals, a marked reduction in the overall incidence of rubella, and prevention of epidemics of congenital rubella syndrome (CRS).2 The major impact has been on young school-aged children, among whom rubella incidence decreased 89% between 1966-1968 and 1975-1977. Unfortunately, less progress has been made in controlling
Orenstein WA, Greaves WL. Congenital Rubella Syndrome: A Continuing Problem. JAMA. 1982;247(8):1174–1175. doi:10.1001/jama.1982.03320330070033
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