Rubella in Israel after the MMR vaccine: elimination or containment?

Abstract:

:Since 1996, after the full institution of the two-dose measles, mumps, and rubella vaccine (MMR) regimen in Israel, rubella incidence has declined dramatically and has remained extremely low. Cyclical outbreaks ended; the two brief outbreaks that did occur were quickly contained; and epidemiological data indicate that the disease is practically absent from the country. But similar steep declines in the incidence of measles and mumps, the two other MMR-preventable diseases, were followed by major outbreaks in 2007 and 2010. Epidemiological analyses show that undervaccination of subgroups within the Jewish ultra-orthodox population, both in Israel and abroad, and virus importation into Israel, continue to be risk factors for all three MMR-preventable diseases. Israel's public health system, therefore, should focus on a policy of containment: improve MMR coverage among undervaccinated subgroups and assure that virus importation is no longer a risk. Then the goal of rubella elimination will become feasible. We discuss how the Israeli experience may contribute to the World Health Organization Initiative to eliminate simultaneously measles and rubella.

journal_name

J Public Health Policy

authors

Anis E,Grotto I,Moerman L,Kaliner E,Warshavsky B,Slater PE,Lev B

doi

10.1057/jphp.2013.8

subject

Has Abstract

pub_date

2013-05-01 00:00:00

pages

288-301

issue

2

eissn

0197-5897

issn

1745-655X

pii

jphp20138

journal_volume

34

pub_type

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