Epidemiology of congenital rubella and results of rubella vaccination in Australia.

Congenital rubella was not notifiable in Australia until recently, but the national incidence of childhood deafness has been accurately documented since 1949. On the basis of these data and a study of congenital rubella in Western Australia, it is estimated that the national incidence of congenital rubella has decreased from a mean of at least 120 cases annually (one in 2,000 live births) to approximately 20 or less since 1977. This decrease has occurred since the introduction of rubella vaccination programs in 1971. The aim of these programs was to reduce the incidence of congenital infection by vaccinating girls (aged 10-14 years) at school without assessing their immunity. Nonpregnant seronegative women were also offered vaccination in family planning clinics as were postpartum seronegative women in obstetric units. By 1983, 96% of 8,226 pregnant women were seropositive for rubella antibody, as compared with only 82% of a similar group of women in 1971. This improvement in the immune status of pregnant women appears to be the result of rubella vaccination. Rubella vaccination also appears to have been successful in preventing congenital infection.