The virtual elimination of rubella is one of the many great vaccine success stories. In the last big rubella epidemic in the U.S., there were 11,250 abortions and 2,100 neonatal deaths. Since that outbreak in the mid-1960s, vaccinations have ended endemic rubella transmission in the U.S.
Other countries, however, have less developed vaccination programs. Consequently, the U.S. still sees some rubella cases most years as people bring the virus from overseas. Last year there were three cases, bringing the total since 2004 up to 79, the Centers for Disease Control and Prevention reports. The three cases in 2012--all of which were linked to Africa--caused an array of conditions in the affected infants, including cataracts, cardiac defects and impaired hearing. None of these cases spread, but the CDC warns that clusters of unvaccinated people are at risk, as was seen in outbreaks in the Netherlands and Canada in recent years.
Low vaccination rates in Wales are being blamed for a recent measles outbreak that resulted in more than 430 cases, and 51 hospitalizations, in one town. Japan has also suffered. Despite introducing the measles, mumps and rubella (MMR) vaccine in 1989, Japan has a patchy record with inoculating against rubella. Health scares put many Japanese off MMR, and in 1993 it was dropped in favor of a dedicated vaccine for rubella. Even so, support for the rubella vaccine remained low. Japan Times describes the 1990s as leading to an entire generation of people lacking protection against rubella.
Now Japan is feeling the effect of its poor inoculation record. From Jan. 1 to March 21 this year, Japanese health authorities reported 2,021 cases of rubella, a 22-fold increase over the same period 12 months ago. The relatively low vaccination rate has facilitated the rapid spread of rubella across Japan. In 2012, a Japanese government survey found 15% of men aged 20 to 49 lack the rubella antibody. The vaccination rate is particularly low in men, because before 1995 only girls were routinely offered the shot. Protection during pregnancy was the goal, but Japan came to realize its gender-specific vaccination program was doing little to stop rubella outbreaks.