Progress Toward Rubella Elimination - World Health Organization South-East Asia Region, 2013-2021.

Area of Science:

• Public Health
• Vaccinology
• Infectious Disease Epidemiology

Background:

• The World Health Organization (WHO) South-East Asia Region (SEAR) set ambitious goals for measles and rubella elimination by 2020 and 2023.
• Prior to 2013, rubella-containing vaccine (RCV) introduction was limited in SEAR countries.

Purpose of the Study:

• To report on the progress of rubella elimination in SEAR from 2013 to 2021.
• To assess the impact of RCV introduction and supplementary immunization activities (SIAs) on rubella incidence.

Main Methods:

• Analysis of routine immunization coverage data for RCV.
• Review of data from RCV supplementary immunization activities (SIAs).
• Monitoring of reported rubella incidence rates across SEAR countries.

Main Results:

• All 11 SEAR countries now utilize RCV in routine immunization programs.
• Routine RCV first dose (RCV1) coverage surged from 12% in 2013 to 86% in 2021.
• An estimated 515 million individuals received RCV through SIAs between 2013 and 2021.
• Reported annual rubella incidence decreased by 80%, from 5.5 to 1.1 cases per million population.
• Maldives and Sri Lanka achieved verified rubella elimination; Bhutan, North Korea, and Timor-Leste halted endemic transmission.

Conclusions:

• SEAR has demonstrated significant advancements in rubella control and elimination efforts.
• Sustained and intensified public health interventions are necessary to achieve complete regional rubella elimination.