Models of strategies for control of rubella and congenital rubella syndrome—A 40 year experience from Australia |
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Authors: | Zhanhai Gao James G Wood Margaret A Burgess Robert I Menzies Peter B McIntyre C Raina MacIntyre |
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Institution: | 1. School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia;2. National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), University of Sydney, Westmead, NSW 2145, Australia |
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Abstract: | We investigated the impact of vaccination on rubella epidemiology in Australia, using a mathematical model fitted to Australian serosurvey data and incorporating pre-vaccination European estimates of rubella transmissibility. Mass infant measles–mumps–rubella (MMR) vaccination produced a 99% reduction in both rubella and congenital rubella syndrome (CRS) incidence by 2010 compared to the pre-vaccination era (1960–70). The model is consistent with reductions in CRS based on surveillance of congenital hearing impairment. Model simulations suggest that selective schoolgirl vaccination (1971–88) was associated with a 90% reduction in CRS incidence, but only a 1–4% reduction in rubella incidence. Our model predicted that these reductions in rubella were much less vulnerable to reductions in MMR vaccine coverage than for measles. In the future, a less than 15% decrease in MMR vaccine coverage is estimated to have minimal impact before 2060, but a 20% reduction may result in a 7-fold increase in rubella incidence, with the effective reproductive number R rising from 0.28 to 0.78 by 2060. The 99% reduction in both rubella and CRS incidence and low effective reproductive number (R ≤ 0.28) we documented after 2010 are consistent with Australia having achieved rubella elimination. |
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Keywords: | Modelling Rubella Vaccination (immunization) Congenital rubella syndrome |
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