Economic evaluation of different vaccination programmes to prevent congenital rubella.

Vaccination against rubella was introduced in Norway in 1978. Without any vaccination policy the frequency of congenital rubella is estimated at 0.4 per 1000 births. In this paper the consequences and effectiveness of the various vaccination programmes are evaluated by applying a cost benefit model. Economically, all strategies to prevent congenital rubella turn out to be cost effective. However, based on the benefit/cost ratios and the net benefit the following recommendation can be made: vaccination, preferentially with the polyvalent vaccine, should be offered to all girls in puberty as a permanent running programme. In addition, this policy should be supplemented for one or two decades with a programme offering vaccination to non-immunized women after delivery and to women especially at risk of exposure. However, if the participation and acceptance rate of the vaccination is less than 100%, permanent vaccination offered at two different ages (i e in childhood and in puberty) gives the best results in the prevention of congenital cases.