This favourable outcome was made possible by a systematic programme to achieve high vaccination coverage in the USA.

As shown in the slide, by 1972 more than 50% of children in all age-groups were vaccinated.

Furthermore, in 1977 the National Immunization Initiative and in 1978 the Measles Elimination Program were undertaken which increased vaccination uptake more. Since 1980, more than 95% of children entering school in the USA are vaccinated for rubella.

A programme to vaccinate susceptible women of childbearing age was also established.

(Source of data: a/ Preblud SR, Serdula MK, Frank JA, Brandling-Bennett AD, Hinman AR. Rubella vaccination in the United States: a ten-year review. Epidemiol Rev 1980; 2:171-94, b/ Orenstein WA, Bart KJ, Hinman AR, Preblud SR, Greaves WL, Doster SW et al. The opportunity and obligation to eliminate rubella from the United States. JAMA 1984; 251:1988-94)