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Quantitative investigations of different vaccination policies for the control of congenital rubella syndrome (CRS) in the United Kingdom

Published online by Cambridge University Press:  19 October 2009

R. M. Anderson  and
B. T. Grenfell
R. M. Anderson
Affiliation:
Parasite Epidemiology Research Group, Department of Pure and Applied Biology, Imperial College, London University, London SW7 2BB, England
B. T. Grenfell
Affiliation:
Parasite Epidemiology Research Group, Department of Pure and Applied Biology, Imperial College, London University, London SW7 2BB, England
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The paper examines predictions of the impact of various one-, two- and three-stage vaccination policies on the incidence of congenital rubella syndrome (CRS) in the United Kingdom with the aid of a mathematical model of the transmission dynamics of rubella virus. Parameter estimates for the model are derived from either serological data or case notifications, and special attention is given to the significance of age-related changes in the rate of exposure to rubella infection and heterogeneous mixing between age groups. Where possible, model predictions are compared with observed epidemiological trends.

The principal conclusion of the analyses is that benefit is to be gained in the UK, both in the short and long term, by the introduction of a multiple-stage vaccination policy involving high levels of vaccination coverage of young male and female children (at around two years of age) and teenage girls (between the ages of 10–15 years), plus continued surveillance and vaccination of adult women in the child-bearing age classes. Model predictions suggest that to reduce the incidence of CRS in future years, below the level generated by a continuation of the current UK policy (the vaccination of teenage girls), would require high rates of vaccination > 60%) of both boys and girls at around two years of age. Numerical studies also suggest that uniform vaccination coverage levels of greater than 80–85% of young male and female children could, in the long term (40 years or more), eradicate rubella virus from the population. The robustness of these conclusions with respect to the accuracy of parameter estimates and various assumptions concerning the pattern of age-related change in exposure to infections and ‘who acquires infection from whom’ is discussed.

Type
Research Article
Information
Journal of Hygiene , Volume 96 , Issue 2 , April 1986 , pp. 305 - 333
Copyright
Copyright © Cambridge University Press 1986

References

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