Orenstein W A, Bart K J, Hinman A R, Preblud S R, Greaves W L, Doster S W, Stetler H C, Sirotkin B
JAMA. 1984 Apr 20;251(15):1988-94.
The licensure of rubella vaccines in the United States in 1969 offered the opportunity to prevent the devastating consequences of congenital rubella infection, including miscarriages, therapeutic abortions, and congenital rubella syndrome (CRS), with its average lifetime cost of more than $220,000 per case. With the widespread use of vaccine, rubella transmission in the United States has been reduced to record low levels. Epidemics of rubella and CRS, previously reported every six to nine years, have not occurred, and since 1980, following decreases of rubella incidence rates in the postpubertal population, the endemic incidence rates of CRS have also begun to decrease. We have both the opportunity and the obligation to hasten elimination by (1) ensuring that susceptible females of childbearing age are vaccinated, (2) initiating and/or enforcing existing legislation requiring proof of rubella immunity for all children enrolled in schools, (3) intensifying surveillance for both acquired rubella and CRS, and (4) aggressively controlling rubella outbreaks.
1969年风疹疫苗在美国获得许可，这为预防先天性风疹感染的灾难性后果提供了契机，这些后果包括流产、治疗性堕胎以及先天性风疹综合征（CRS），每例CRS的终生平均费用超过22万美元。随着疫苗的广泛使用，美国风疹传播已降至历史最低水平。以前每六到九年就会出现的风疹和CRS疫情已不再发生，自1980年以来，青春期后人群中风疹发病率下降后，CRS的地方性发病率也开始下降。我们既有机会也有义务通过以下方式加速消除风疹：（1）确保育龄易感女性接种疫苗；（2）启动和/或执行现有立法，要求所有入学儿童提供风疹免疫证明；（3）加强对获得性风疹和CRS的监测；（4）积极控制风疹疫情。
