{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T21:29:18Z","timestamp":1767907758498,"version":"3.49.0"},"reference-count":43,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2017,12,4]],"date-time":"2017-12-04T00:00:00Z","timestamp":1512345600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:title>SUMMARY<\/jats:title><jats:p>Rubella virus infection typically presents as a mild illness in children; however, infection during pregnancy may cause the birth of an infant with congenital rubella syndrome (CRS). As of February 2017, India began introducing rubella-containing vaccine (RCV) into the public-sector childhood vaccination programme. Low-level RCV coverage among children over several years can result in an increase in CRS incidence by increasing the average age of infection without sufficiently reducing rubella incidence. We evaluated the impact of RCV introduction on CRS incidence across India's heterogeneous demographic and epidemiological contexts. We used a deterministic age-structured model that reflects Indian states\u2019 rural and urban area-specific demography and vaccination coverage levels to simulate rubella dynamics and estimate CRS incidence with and without RCV introduction to the public sector. Our analysis suggests that current low-level private-sector vaccination has already slightly increased the burden of CRS in India. We additionally found that the effect of public-sector RCV introduction depends on the basic reproductive number,<jats:italic>R<\/jats:italic><jats:sub>0<\/jats:sub>, of rubella. If<jats:italic>R<\/jats:italic><jats:sub>0<\/jats:sub>is five, a value empirically estimated from an array of settings, CRS incidence post-RCV introduction will likely decrease. However, if<jats:italic>R<\/jats:italic><jats:sub>0<\/jats:sub>is seven or nine, some states may experience short-term or annual increases in CRS, even if a long-term total reduction in cases (30 years) is expected. Investment in population-based serological surveys and India's fever\/rash surveillance system will be key to monitoring the success of the vaccination programme.<\/jats:p>","DOI":"10.1017\/s0950268817002527","type":"journal-article","created":{"date-parts":[[2017,12,4]],"date-time":"2017-12-04T05:27:03Z","timestamp":1512365223000},"page":"65-77","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":14,"title":["Rubella vaccination in India: identifying broad consequences of vaccine introduction and key knowledge gaps"],"prefix":"10.1017","volume":"146","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2737-7003","authenticated-orcid":false,"given":"A. 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E.","family":"METCALF","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2017,12,4]]},"reference":[{"key":"S0950268817002527_ref37","doi-asserted-by":"publisher","DOI":"10.1016\/0040-5809(90)90003-E"},{"key":"S0950268817002527_ref40","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0016965"},{"key":"S0950268817002527_ref34","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2015.01.083"},{"key":"S0950268817002527_ref29","unstructured":"World Health Organization. Immunization surveillance, assessment and monitoring: recent immunization data, 2015 (http:\/\/www.who.int\/immunization\/monitoring_surveillance\/data\/en\/). 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Strategic plan for measles elimination and rubella and congenital rubella syndrome control in the south-east Asia region. 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Rapid Survey on Children (2013\u201314): India and state fact sheets, 2016 (http:\/\/wcd.nic.in\/acts\/rapid-survey-children-rsoc-2013-14). Accessed 4 January 2017."},{"key":"S0950268817002527_ref18","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268800004672"},{"key":"S0950268817002527_ref6","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/9.1.13"},{"key":"S0950268817002527_ref28","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.07.041129"},{"key":"S0950268817002527_ref16","doi-asserted-by":"crossref","DOI":"10.1093\/oso\/9780198545996.001.0001","volume-title":"Infectious Diseases of Humans: Dynamics and Control","author":"Anderson","year":"1991"},{"key":"S0950268817002527_ref25","doi-asserted-by":"publisher","DOI":"10.1111\/1467-9876.00233"},{"key":"S0950268817002527_ref33","doi-asserted-by":"publisher","DOI":"10.1098\/rstb.2012.0141"},{"key":"S0950268817002527_ref32","unstructured":"Ministry of Health and Family Welfare, Government of India. Introduction of measles-rubella vaccine (campaign and routine immunization): National operational guidelines. Technical report, 2016 (http:\/\/www.searo.who.int\/india\/topics\/measles\/measles_rubella_vaccine_guidelines.pdf?ua=1)."}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268817002527","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,29]],"date-time":"2024-06-29T10:33:11Z","timestamp":1719657191000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268817002527\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12,4]]},"references-count":43,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2018,1]]}},"alternative-id":["S0950268817002527"],"URL":"https:\/\/doi.org\/10.1017\/s0950268817002527","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,12,4]]},"assertion":[{"value":"Copyright \u00a9 Cambridge University Press 2017\u00a0This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}