Prevalence of antibodies against rubella virus in the Netherlands 9 years after changing from selective to mass vaccination

A two-dose mass vaccination programme with a combined vaccine against measl es, mumps and rubella (MMR) was adopted in the Netherlands in 1987, replaci ng the selective schoolgirl vaccination strategy introduced in 1974. To obt ain insight into the effect of mass vaccination and the population's immuni ty, the antibody levels against rubella were studied in the general Dutch p opulation and in religious groups refusing vaccination. In the national sam ple, we observed a high prevalence (96.5%) for rubella antibodies in vaccin ated cohorts as well as in the older unvaccinated cohorts. No indications o f rapidly waning immunity after vaccination were found. There are indicatio ns of low virus circulation in the last few years. The Very high seropreval ence in women at childbearing age is consistent with the few reported cases of congenital rubella syndrome (CRS) at present. However, individuals in t he age group of 1-9 years who are not vaccinated for religious or other rea sons have a considerably lower seroprevalence and thus there is a potential risk of a CRS outbreak in the future.