Benefit-cost analysis of rubella vaccination policy.

To analyze rubella vaccination strategies we calculated benefits and costs of prevention or rubella. With no vaccination, lifetime expenditures for congenital rubella syndrome in offspring of females are greater than $35 per female (present value). Expenditures for acute rubella are less than $2.70 per person. Cost, when monovalent vaccine is used, is $3.00 per person. Vaccination of females at 12 years of age yields net benefits 80 per cent larger than vaccination of children at two. When only 80 per cent of the target group accepts vaccine, vaccination at 12 years reduces congenital rubella by 30 per cent more than vaccination at six or two. Vaccination at two and revaccination at 12 (with 80 per cent acceptance at each age) reduces expected natural infections by 80 per cent and expected congenital rubella by 95 per cent. Either single vaccination of females at 12 years or vaccination at two ages would be better than current United States practice of vaccinating children once at an early age.