Abstract
Japan experienced 2 large rubella epidemics in 2004 and 2012–2014. Because of suboptimal immunization levels, the country has been experiencing a third major outbreak during 2018–2020. We conducted time series analyses to evaluate the effect of the 2012–2014 nationwide rubella epidemic on prefecture-level natality in Japan. We identified a statistically significant decline in fertility rates associated with rubella epidemic activity and increased Google searches for the term “rubella.” We noted that the timing of fertility declines in 2014 occurred 9–13 months after peak rubella incidence months in 2013 in 4 prefectures with the highest rubella incidence. Public health interventions should focus on enhancing vaccination campaigns against rubella, not only to protect pregnant women from infection but also to mitigate declines in population size and birth rates.
Highlights
Japan experienced 2 large rubella epidemics in 2004 and 2012–2014
We examined the effects of Japan’s large rubella outbreak during 2012–2014 on behavioral changes among women of childbearing age by quantifying the temporal changes in fertility rates and rubella cases in 4 prefectures of Japan that experienced the brunt of the 2013 rubella epidemic
We assessed the effect of the 2012–2014 rubella epidemic on prefecture-level natality in Japan
Summary
Japan experienced 2 large rubella epidemics in 2004 and 2012–2014. Because of suboptimal immunization levels, the country has been experiencing a third major outbreak during 2018–2020. Because of suboptimal immunization levels, Japan is experiencing a third major rubella outbreak that began in 2018 [5,6,7]. This epidemic has resulted in 5,296 reported cases as of April 12, 2020, and has affected all 47 prefectures by the 13th week of 2020 [8]. We examined the effects of Japan’s large rubella outbreak during 2012–2014 on behavioral changes among women of childbearing age by quantifying the temporal changes in fertility rates and rubella cases in 4 prefectures of Japan that experienced the brunt of the 2013 rubella epidemic
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