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Epidemiology of rubella in Finland

I Davidkin1, H Peltola, P Leinikki

  • 1National Public Health Institute (KTL), Helsinki, Finland.

Euro Surveillance : Bulletin Europeen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin
|June 12, 2004
PubMed

Insights

Finland successfully eliminated rubella through its high-coverage measles, mumps, and rubella (MMR) vaccination program. This initiative has also eradicated congenital rubella syndrome, demonstrating vaccine effectiveness.

Area of Science:

  • Immunology
  • Epidemiology
  • Public Health

Background:

  • Rubella was historically endemic in Finnish children, causing periodic epidemics.
  • Rubella infection commonly occurred in children aged 2-12 years before vaccination.
  • Disease surveillance indicated epidemic cycles occurring every few years.

Purpose of the Study:

  • To evaluate the long-term impact of rubella vaccination programs in Finland.
  • To assess the effectiveness of the measles, mumps, and rubella (MMR) vaccination program in disease elimination.
  • To determine the cessation of indigenous rubella virus circulation and congenital rubella syndrome (CRS) incidence.

Main Methods:

  • Analysis of historical rubella incidence data before and after vaccination introduction.
  • Monitoring of vaccination coverage rates from the mid-1970s onwards.
  • Surveillance of imported rubella cases and secondary infections post-elimination.
  • Cohort studies to assess vaccine-induced antibody levels over time.

Main Results:

  • Rubella cases significantly reduced following the MMR vaccination program launch in 1982.
  • Indigenous rubella virus circulation ceased in Finland by the late 1990s due to sustained high vaccination coverage (>95%).
  • Congenital rubella syndrome (CRS) was eliminated, with the last case in 1986.
  • Imported rubella cases did not result in secondary transmission, indicating effective population immunity.
  • Cohort studies suggest a gradual decrease in vaccine-induced antibody levels over time.

Conclusions:

  • The high-coverage, two-dose MMR vaccination program successfully eliminated rubella and congenital rubella syndrome in Finland.
  • Sustained population immunity effectively prevents sustained transmission of indigenous rubella virus.
  • Ongoing monitoring is necessary to ascertain the duration of vaccine-induced protection.

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