Version 1
: Received: 24 April 2024 / Approved: 25 April 2024 / Online: 25 April 2024 (10:15:12 CEST)
How to cite:
Frey, K. Congenital Rubella Syndrome Burden is Unlikely to Increase with Introduction of Rubella Containing Vaccine. Preprints2024, 2024041658. https://doi.org/10.20944/preprints202404.1658.v1
Frey, K. Congenital Rubella Syndrome Burden is Unlikely to Increase with Introduction of Rubella Containing Vaccine. Preprints 2024, 2024041658. https://doi.org/10.20944/preprints202404.1658.v1
Frey, K. Congenital Rubella Syndrome Burden is Unlikely to Increase with Introduction of Rubella Containing Vaccine. Preprints2024, 2024041658. https://doi.org/10.20944/preprints202404.1658.v1
APA Style
Frey, K. (2024). Congenital Rubella Syndrome Burden is Unlikely to Increase with Introduction of Rubella Containing Vaccine. Preprints. https://doi.org/10.20944/preprints202404.1658.v1
Chicago/Turabian Style
Frey, K. 2024 "Congenital Rubella Syndrome Burden is Unlikely to Increase with Introduction of Rubella Containing Vaccine" Preprints. https://doi.org/10.20944/preprints202404.1658.v1
Abstract
Rubella infection is typically mild or asymptomatic except when infection occurs during pregnancy. Infection in early pregnancy can cause miscarriage, stillbirth, or congenital rubella syndrome. Only individuals that are still susceptible to rubella infection during child-bearing age are vulnerable to this burden. Rubella containing vaccine (RCV) is safe and effective, providing life-long immunity. However, average age-at-infection increases with increasing vaccination coverage, which could potentially lead to increased disease burden as well, if the absolute risk of infection during child-bearing age increases. Dynamics of rubella transmission were explored using EMOD, a software tool for building stochastic, agent-based infection models. Simulations of pre-vaccine, endemic transmission of rubella virus introduced RCV at varying levels of coverage to determine the expected future trajectories of disease burden. Introducing RCV reduces both rubella virus transmission and disease burden for a period of around 15 years. Increased disease burden is only possible more than a decade post-introduction, and only for contexts with low current burden and high transmission intensity. Low or declining rubella virus transmission intensity is concurrently associated with both greater disease burden and greater vaccine effectiveness. The risk of increasing burden through vaccination only exists for locations with persistently high infectivity, high connectivity, and high fertility. A trade-off between the risk of a small, future burden increase and a large, immediate burden decrease strongly favors RCV introduction.
Keywords
rubella; congenital rubella syndrome; vaccine introduction; agent-based model
Subject
Public Health and Healthcare, Public Health and Health Services
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
