Progress Toward Rubella and Congenital Rubella Syndrome Elimination - Worldwide, 2012-2024

Rubella is the leading cause of vaccine-preventable birth defects. Rubella virus infection during pregnancy can result in miscarriage, fetal death, stillbirth, or a constellation of birth defects known as congenital rubella syndrome (CRS). Vaccination is the primary method for preventing rubella and CRS, and a single dose of rubella-containing vaccine (RCV) provides lifelong protection. In 2024, the World Health Organization recommended introduction of RCV in all countries. Achieving rubella elimination is a priority of the Immunization Agenda 2030. This report summarizes global progress toward elimination of rubella and CRS during 2012-2024. During this period, the number of countries that introduced RCV increased from 132 of 194 (68%) to 179 (92%), and global coverage with the first routinely scheduled dose of RCV rose from 39% to 73%. The number of reported rubella cases declined by 66%, from 94,277 in 2012 to 31,593 in 2024, with large outbreaks increasingly concentrated in fewer countries and geographic shifts observed as vaccine introductions advanced. Modeled estimates suggest that CRS cases declined by approximately 70% during the same period. Since 2012 when accelerated rubella control activities began, 117 of 194 (60%) countries have verified elimination of endemic rubella virus transmission. Despite this, in 2024, approximately 21 million infants aged 12-23 months lived in the 15 countries that had not introduced RCV. Although substantial progress has been made, achieving and sustaining rubella and CRS elimination will require RCV introduction in all the remaining countries and continued commitment from all countries to strengthen immunization and surveillance systems.