Selective immunization: protection of the individual

Selective immunization was adopted in the United Kingdom on account of doubts about the duration of vaccine-induced immunity. Selective immunization of a particular age group had already been established as an effective procedure with bacille Calmette-Guérin (BCG) vaccine, so that practical experience was available. Initially, girls aged 11-14 years were vaccinated, but the program was extended over a 14-year period to include other groups, mainly susceptible women and other at-risk individuals. Cases of congenital rubella continue to occur, although there are signs of a decline in incidence. The number of terminations of pregnancy related to rubella in any form is high. The vaccination acceptance rate for girls aged 10-14 years increased from 35% in 1972 to 85% in 1982. The low rate of measles vaccination is considered to be a major reason for continuing with the present scheme rather than changing to the American or Swedish schemes of vaccination of preschool children with combined vaccines. A new initiative to promote rubella vaccination has recently been introduced in the United Kingdom in which charitable institutions would work together with health authorities to promote immunization against rubella.