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CDC recommends introducing rubella-containing vaccine into routine vaccination
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CDC officials are urging WHO member states to evaluate the burden of disease posed by congenital rubella syndrome in their regions and implement rubella-containing vaccine into routine immunization schedules if appropriate.
As of December 2009, 130 of 193 WHO member states have introduced rubella-containing (RCV) vaccine into national immunization schedules, including 4% of 46 member states in the African Region (AFR); all 35 member states in the Region of the Americas (AMR); 71% of 21 in the Eastern Mediterranean Region (EMR); all 53 in the European Region (EUR); 36% of 11 in the South-East Asian Region (SEAR); and 78% of 27 in the Western Pacific Region (WPR).
Recommendations in 94% of these member states suggest the first dose of RCV be administered between ages 12 and 24 months. CDC researchers noted that, while only one dose is recommended, 92% of member states employ a two-dose schedule because they use a combination rubella and measles vaccine.
Eighty-eight percent of these member states administer the measles-mumps-rubella vaccine, 9% use the measles-rubella vaccine and 2% offer the measles-mumps-rubella-varicella vaccine. One member state also uses single-antigen rubella vaccine, according to the CDC data published in the Oct. 15th issue of Morbidity and Mortality Weekly Report.
An 82% decrease in rubella cases from 2000 to 2009 in 102 member states was reported to WHO, according to the researchers. A nearly 100% decline in cases occurred in the AMR during this time, with the number of reporting states increasing from 25 to 34.
EUR reported similar results with the number of cases decreasing by 98%. Reporting states in this region also increased from 41 to 46.
The number of rubella cases rose 20-fold in AFR, 14-fold in SEAR and 12-fold in WPR, with the number of reporting states also increasing in these regions. The researchers said, however, that reporting of rubella and CRS cases depends on the amount and quality of surveillance systems among member states.
“As a country makes progress on rubella control and CRS prevention, the quality of surveillance improves to monitor the effectiveness of the vaccination program and the number of reported cases might increase even when the actual number of infections decreases,” they wrote.
The researchers also said that, while two-thirds of all WHO member states incorporated RCV into their national routine vaccination programs in 2009, these member states only represent less than half of the global birth cohort.
“As other member states consider RCV introduction, the potential risk needs to be considered that rubella virus transmission dynamics might be altered such that susceptibility might increase among women of childbearing age, resulting in increased risk for CRS,” they wrote.
Therefore, achieving and maintaining high vaccination coverage is essential.
For more information:
- CDC. MMWR. 2010; 59:1307-1310.