Policies for immunization against rubella in European countries.

In 1986 a survey on immunization policies against rubella was conducted in 17 European countries. A questionnaire was sent to each Ministry of Health and selected practitioners, requesting information on official policy for vaccination against rubella, level of policy decision, immunization strategy, target groups, current recommendations for vaccination, measures taken to facilitate vaccine uptake, vaccine strains used and legislation concerning abortion. A policy for the prevention of congenital rubella is explicitly defined in 16 countries (in 12 at a national level, in 3 at a regional level and in one at both levels). In Greece only, no official policy has been defined, although the practice is to vaccinate infants over 15 months of age and girls by 9-11 years of age. There are 3 countries maintaining the selective strategy of vaccinating teenage girls, but in 8 countries this strategy changed to a mass vaccination of young infants. In 5 other countries an approach combining both mass immunization and selective vaccination is adopted. This situation of different strategies between countries in Europe could have a deleterious effect for young migrants or travelling pregnant women and could reduce the effectiveness of programmes for prevention of congenital rubella syndrome. Harmonization of immunization policies and of recommendations for vaccine administration is advisable. The mass vaccination of all young children combined with systematic revaccination either of all children or of teenage girls is probably the most effective approach for elimination of congenital rubella syndrome in Europe.