Failure of Rubella Herd Immunity during an Epidemic

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Abstract
Between January 8 and May 20, 1971, over one thousand cases of rubella occurred in Casper, Wyoming. Eighty-four per cent of these cases were in persons 12 to 18 years old; 27 cases occurred in women, seven of whom were pregnant. Nine months before the epidemic, a rubella vaccination program had been conducted in this community in which 83 per cent of elementary-school children and 52 per cent of preschool children were vaccinated. During the epidemic the attack rate for all preschool and elementary-school children was 1 per cent; for those in grades eight through 12, the attack rate was approximately 15 per cent. The concept that a highly immune group of prepubertal children will prevent the spread of rubella in the rest of the community was shown by this epidemic not always to be valid.

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