The evolving landscape of rubella in the WHO African Region

Introduction: as of the end of 2024, a total of 35 countries in the World Health Organization (WHO) African Region have introduced rubella vaccine. Globally, rubella cases declined by 81% between 2012 and 2022. We looked at the overall trends of rubella occurrence, comparing the reported cases before and following rubella vaccine introduction. Methods: we analyzed the vaccination coverage as well as rubella surveillance and laboratory confirmation data from countries in the African Region. Results: the regional coverage with the first dose of rubella-containing vaccine was 36% in 2023. Between 2009 and 2024, a total of 27,954 rubella laboratory confirmed cases were reported through the case-based surveillance system from the 26 countries that had introduced rubella vaccine by 2018, of which 18% were reported in the years after the vaccine introduction. Among 19 of the 26 countries which had good surveillance performance, there was an average 76% reduction in the reported number of rubella cases following vaccine introduction. Conclusion: the level of reduction of rubella cases after vaccine introduction observed in this study is comparable to the findings from other regions. Maintaining high population immunity and good quality disease surveillance is critical to verify elimination.