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Vaccine. 2016 Nov 10. pii: S0264-410X(16)31022-2. doi: 10.1016/j.vaccine.2016.10.072. [Epub ahead of print]
Abrams S1 Kourkouni E2 Sabbe M3 Beutels P4 Hens N5.
Rubella is usually a mild disease for which infections often pass by unnoticed. In approximately 50% of the cases there are no or only few clinical symptoms. However rubella contracted during early pregnancy could lead to spontaneous abortion to central nervous system defects or to one of a range of other serious and debilitating conditions in a newborn such as the congenital rubella syndrome. Before the introduction of mass vaccination rubella was a common childhood infection occurring all over the world. However since the introduction of rubella antigen-containing vaccines the incidence of rubella has declined dramatically in high-income countries. Recent large-scale mumps outbreaks one of the components in the combined measles-mumps-rubella vaccine occurring in countries throughout Europe with high vaccination coverage provide evidence of pathogen-specific waning of vaccine-induced immunity and primary vaccine failure. In addition recent measles outbreaks affecting populations with suboptimal vaccination coverages stress the importance of maintaining high vaccination coverages. In this paper we focus on the assessment of rubella outbreak risk using a previously developed method to identify geographic regions of high outbreak potential. The methodology relies on 2006 rubella seroprevalence data and vaccination coverage data from Belgium and information on primary and secondary vaccine failure obtained from extensive literature reviews. We estimated the rubella outbreak risk in Belgium to be low however maintaining high levels of immunisation and surveillance are of utmost importance to avoid future outbreaks.