Measles, mumps and rubella: Present and future immunisation policy

Abstract

Selective rubella vaccination has achieved a substantial reduction in the incidence of rubella infection in pregnancy and its inevitable sequelae of congenital rubella syndrome (CRS) births and therapeutic abortions. However, recent epidemiological evidence has shown that the number of infections among the 2–3% of pregnant women still susceptible remains unacceptably high and that there is no prospect of eliminating CRS with selective vaccination alone. The current policy will therefore be augmented by mass rubella vaccination using a combined measles/mumps/rubella (MMR) vaccine. The aim is to prevent the circulation of rubella thereby protecting susceptible pregnant women from exposure. The target will be to vaccinate every child of both sexes for whom there is no valid contradiction. As part of this new initiative, measures are being taken to increase professional commitment and to make Districts accountable to DHSS for their immunisation performance. Surveillance of the effect of the MMR programme will include monitoring of vaccine uptake, disease incidence and age-specific antibody prevalence to measles, mumps and rubella. Surveillance data will be used to guide the new policy towards the goal of elimination of measles, mumps, rubella and CRS in the UK.