A Cost-Benefit Analysis of a Mandatory Premarital Rubella-Antibody Screening Program

In 1969, two attenuated rubella vaccines were licensed for use in the United States. Since that time, the practice in this country has been to immunize school-age children to reduce the reservoir and spread of the virus.1 This policy is in contrast with the immunization strategy of the United Kingdom, which is to vaccinate only girls 10 to 14 years of age who do not have detectable hemagglutination-inhibiting antibodies to rubella virus.2 Although little has been written about the success of the British strategy, continual outbreaks of rubella in the United States are indicative of the difficulty in achieving herd . . .