[Current state of the world's experiences with vaccination against rubella]

In order to avoid the severe consequences that may result from intrauterine infection, the prevention of maternal rubella is of most importance. It should be remarked that the damage induced in the infant by the rubella virus is not confined to the first trimester of pregnancy, but may occur also in the following months, and some lesions, especially the auditive ones, may become worse during the childhood. From an immunological point of view in the present paper it is emphasized the prominent importance of neutralizing antibodies; these should be more broadly assayed in epidemiological investigations and in studies concerning the effects of the different vaccines that are available nowadays. In this connection, the RA 27/3 vaccine (prepared with human diploid cells) appears to be more effective than other vaccines (e.g.: Cendehill and HPV-77) in stimulating the formation of circulating antibodies. Furthermore this vaccine, which may be administrated intranasally, can produce a local resistence due to the presence of specific IgA in the secretions. The following programs have been proposed for the prevention of rubella: a mass-vaccination (as in the United States) and a selective vaccination of female prepubere subjects who appear to be non protected against the infection. The Authors consider the second program as the more advantageous and suggest that the age range should be 10-11 years. It may be interesting to note that a new anti-rubella vaccine has been recently employed in Soviet Union with satisfactory results, while an alive attenuate non-teratogenic vaccine has been prepared in Japan. However, the opinion of the Authors is that further studies are needed in order to obtain a really non-teratogenic vaccine and administrable intranasally; this should be the most effective means against all problems correlated to rubella infection.