Most of the countries in western Europe have now implemented mass infant rubella
immunization programmes, instead of or in addition to selective vaccination in order to
achieve the elimination of congenital rubella syndrome.
The European countries Denmark, England and Wales, Finland, France, Germany, Italy and
the Netherlands undertook large, national serological surveys collecting several thousand serum
specimens during 1994–8. Antibodies against rubella virus were detected by a variety of enzyme
immuno-assays. Comparability of the assay results was achieved by a standardized
methodology. The age- and sex-stratified serological results were related to the schedules,
coverage of rubella vaccination and the incidence in these countries.
The results show widely differing levels of immunity to rubella both in the general
population and in the specific age groups of males and females. A low rate (< 5%) of
susceptibles in childhood and adolescents of both sexes was obtained only in Finland and the
Countries such as Italy with only moderate coverage for the infant immunization programme
currently have both high susceptibility levels in the general population and in the at-risk
population. The likelihood is of continued epidemics of rubella with cases of congenital rubella
syndrome. The continued implementation of selective vaccination will help to offset the impact
of this ongoing transmission and to protect women on reaching childbearing age.