Premarital rubella screening program: from identification to vaccination of susceptible women in the state of Hawaii.

Premarital rubella screening programs are effective in identifying women of childbearing age who are susceptible to rubella. There is concern, however, that once identified, susceptible women may not be subsequently vaccinated. Therefore, a study was conducted to test the effectiveness of a motivational letter mailed at the time of serologic testing. Rubella-susceptible women identified by a premarital screening program were randomly divided into two groups: one group of 134 received a motivational letter and one group of 143 did not. Three months later, 52 percent of the women in the motivational group had been vaccinated, compared with only 24 percent (P less than 0.05) of the women in the control group. In this study, a motivational letter was found to lead to a significant increase in rubella vaccination rates among susceptible women. With the increasing emphasis on rubella vaccination programs for adult women, active approaches are necessary to identify and vaccinate susceptible women.