Progress Toward Rubella and Congenital Rubella Syndrome Elimination - Worldwide, 2012-2022

Abstract

Rubella virus is a leading cause of vaccine-preventable birth defects. Infection during pregnancy can result in miscarriage, fetal death, stillbirth, or a constellation of birth defects, including cataracts, deafness, heart defects, and developmental delay, known as congenital rubella syndrome (CRS). A single dose of rubella-containing vaccine can provide lifelong protection against rubella. The Global Vaccine Action Plan 2011-2020 included a target to achieve elimination of rubella in at least five of the six World Health Organization (WHO) regions by 2020, and rubella elimination is a critical goal of the Immunization Agenda 2030. This report updates a previous report and describes progress toward rubella and CRS elimination during 2012-2022. During 2012-2022, among 194 WHO countries, the number that included rubella-containing vaccine (RCV) in their immunization schedules increased from 132 (68%) to 175 (90%) and the percentage of the world's infants vaccinated against rubella increased from 40% to 68%. Reported rubella cases declined 81%, from 93,816 in 2012 to 17,407 in 2022. Verification of rubella elimination was achieved in 98 (51%) of 194 countries by 2022, an increase from 84 (43%) countries in 2019. Despite significant progress in the introduction of RCV into routine immunization programs worldwide, approximately 25 million infants annually still do not have access to RCV. Nevertheless, even in complex settings, the increasing number of countries that have achieved and sustained rubella elimination demonstrates progress toward global rubella elimination.

FIGURE 1

Percentage of World Health Organization countries that introduced rubella-containing vaccine into the routine immunization schedule and the percentage with verified rubella elimination, by year (N = 194) — worldwide, 2012–2022 Abbreviation: RCV = rubella-containing vaccine.

FIGURE 2

Percentage of World Health Organization countries that have introduced rubella-containing vaccine into the routine immunization schedule, by historical World Bank income group and year (N = 194) — worldwide, 2012–2022 * Gross national income per capita in U.S. dollars for 2022: high income ≥ $13,846; upper-middle income = $4,466–$13,845; lower-middle income = $1,136–$4,465; and low income ≤$1,135. https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups ^† In 2022, there were 59 high-income, 49 upper-middle–income, 51 lower-middle–income, 13 low-income, and 22 unclassified countries.