Rubella remains an important pathogen globally with approximately 100,000 cases of congenital rubella syndrome estimated to occur each year. Rubella vaccine is highly effective and safe when used across a population and, as a result, endemic rubella transmission has been interrupted in the Americas since 2009. Incomplete rubella vaccination programs result in continued disease transmission as evidenced by recent large outbreaks in Japan and elsewhere. Herein, we provide current results regarding rubella control, elimination and eradication policies, and a brief review of new laboratory diagnostics. In addition, we provide novel information regarding rubella vaccine immunogenetics and review the emerging evidence of inter-individual variability in humoral and cell-mediated innate and adaptive immune responses to rubella vaccine and their association with HLA alleles, haplotypes, and single nucleotide polymorphisms across the human genome. Finally, we conclude with a call for further research in rubella vaccine immunogenetics and its ability to inform a vaccinomics-level approach to novel vaccine candidate development and the need for a next generation vaccine that is affordable, easy to administer, and does not require a cold chain for optimal immunogenicity.

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Since 1990, the reported incidence of pertussis has increased in the United States with peaks occurring every 3-4 years. On the basis of analysis of pertussis cases reported to the Centers for Disease Control and Prevention, the incidence remained stable among children aged younger than 5 years, most of whom were protected by vaccination. In contrast to 1990-1993, during 1994-1996, the average incidence among persons aged 5-9 years, 10-19 years, and 20 years or older increased 40%, 106%, and 93%, respectively. Since 1990, 14 states reported pertussis incidences of > or =2 cases per 100,000 population during at least 4 years between 1990 and 1996; seven of these states also reported that a high proportion of cases occurred in persons aged 10 years or older. Analysis of national data on pertussis did not provide sufficient information to fully elucidate the relative importance of multiple possible explanations for the increase in the incidence of pertussis in adolescents and adults. Improvement in diagnosis and reporting of pertussis in this age group, particularly in some states, is an important factor contributing to the overall increase.

Values for measles CFRs remain imprecise, resulting in continued uncertainty about the actual toll measles exacts.