Abstract

During the 2012–13 rubella outbreak in Japan, local governments implemented subsidy programs for catch-up vaccination to mitigate the rubella outbreak and prevent congenital rubella syndrome (CRS). In most local governments, to prevent CRS, eligible persons of the subsidy program were women who were planning to have a child and men who were partners of pregnant women. On the other hand, in Kawasaki City, unimmunized men aged 23–39 years were additionally included in the eligible persons, because they were included in an unimmunized men group resulting from the historical transition of the national routine vaccination in Japan. The number of rubella cases in the city decreased earlier than that in the whole Japan. First, in order to estimate the effect of the catch-up vaccination campaign in Kawasaki City on the epidemic outcome, we performed numerical simulations with a Susceptible-Vaccinated-Exposed-Infectious-Recovered (SVEIR) model incorporating real data. The result indicated that the catch-up vaccination campaign showed a beneficial impact on the early decay of the rubella cases. Second, we numerically compared several different implementation strategies of catch-up vaccinations under a fixed amount of total vaccinations. As a result, we found that early and intensive vaccinations are vital for significant reduction in the number of rubella cases and CRS occurrences. Our study suggests that mathematical models with epidemiological and social data can contribute to identifying the most effective vaccination strategy.

Highlights

  • Rubella remains as a worldwide endemic disease, except for the Americas, and its elimination is a crucial issue in public health all over the world [1, 2]

  • We found that an increase in the total amount of vaccination and an early and intensive implementation of the catch-up vaccination program are indispensable for reducing the risk of rubella outbreaks and congenital rubella syndrome (CRS)

  • Motivated by the special catch-up vaccination program in Kawasaki City, we investigated the effectiveness of several possible catch-up vaccination programs on the rubella outbreak, using a mathematical model

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Summary

Introduction

Rubella remains as a worldwide endemic disease, except for the Americas, and its elimination is a crucial issue in public health all over the world [1, 2]. The most serious concern about rubella outbreaks is that rubella infection of a pregnant woman can cause congenital rubella syndrome (CRS) of the developing fetus, associated with miscarriage, foetal death, various severe anomalies including visual and hearing impairment, congenital heart disease, central nervous system damages, and growing retardation [2].

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