Journal of Public Health Policy

, Volume 34, Issue 2, pp 288–301

Rubella in Israel after the MMR vaccine: Elimination or containment?

  • Emilia Anis
  • Itamar Grotto
  • Larisa Moerman
  • Ehud Kaliner
  • Bruce Warshavsky
  • Paul E Slater
  • Boaz Lev
Original Article

DOI: 10.1057/jphp.2013.8

Cite this article as:
Anis, E., Grotto, I., Moerman, L. et al. J Public Health Pol (2013) 34: 288. doi:10.1057/jphp.2013.8

Abstract

Since 1996, after the full institution of the two-dose measles, mumps, and rubella vaccine (MMR) regimen in Israel, rubella incidence has declined dramatically and has remained extremely low. Cyclical outbreaks ended; the two brief outbreaks that did occur were quickly contained; and epidemiological data indicate that the disease is practically absent from the country. But similar steep declines in the incidence of measles and mumps, the two other MMR-preventable diseases, were followed by major outbreaks in 2007 and 2010. Epidemiological analyses show that undervaccination of subgroups within the Jewish ultra-orthodox population, both in Israel and abroad, and virus importation into Israel, continue to be risk factors for all three MMR-preventable diseases. Israel's public health system, therefore, should focus on a policy of containment: improve MMR coverage among undervaccinated subgroups and assure that virus importation is no longer a risk. Then the goal of rubella elimination will become feasible. We discuss how the Israeli experience may contribute to the World Health Organization Initiative to eliminate simultaneously measles and rubella.

Keywords

rubella MMR vaccine subgroups virus importation 

Copyright information

© Palgrave Macmillan, a division of Macmillan Publishers Ltd 2013

Authors and Affiliations

  • Emilia Anis
    • 1
    • 2
  • Itamar Grotto
    • 1
    • 3
  • Larisa Moerman
    • 1
  • Ehud Kaliner
    • 1
  • Bruce Warshavsky
    • 1
  • Paul E Slater
    • 1
    • 2
  • Boaz Lev
    • 1
  1. 1.Division of EpidemiologyMinistry of HealthJerusalemIsrael
  2. 2.Braun School of Public Health, Hebrew University and HadassahJerusalemIsrael
  3. 3.Epidemiology DepartmentFaculty of Health Sciences, Ben-Gurion University of the NegevBeer-ShevaIsrael