Rubella in Israel after the MMR vaccine: Elimination or containment?

Emilia Anis, Itamar Grotto, Larisa Moerman, Ehud Kaliner, Bruce Warshavsky, Paul E. Slater, Boaz Lev

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Since 1996, after the full institution of the two-dose measles, mumps, and rubella vaccine (MMR) regimen in Israel, rubella incidence has declined dramatically and has remained extremely low. Cyclical outbreaks ended; the two brief outbreaks that did occur were quickly contained; and epidemiological data indicate that the disease is practically absent from the country. But similar steep declines in the incidence of measles and mumps, the two other MMR-preventable diseases, were followed by major outbreaks in 2007 and 2010. Epidemiological analyses show that undervaccination of subgroups within the Jewish ultra-orthodox population, both in Israel and abroad, and virus importation into Israel, continue to be risk factors for all three MMR-preventable diseases. Israel's public health system, therefore, should focus on a policy of containment: improve MMR coverage among undervaccinated subgroups and assure that virus importation is no longer a risk. Then the goal of rubella elimination will become feasible. We discuss how the Israeli experience may contribute to the World Health Organization Initiative to eliminate simultaneously measles and rubella.

Original languageEnglish
Pages (from-to)288-301
Number of pages14
JournalJournal of Public Health Policy
Issue number2
StatePublished - 1 May 2013


  • MMR vaccine
  • Rubella
  • Subgroups
  • Virus importation

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health


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