Has the United States population been adequately vaccinated to achieve rubella elimination?

Mathematical models indicate that elimination of rubella virus transmission requires maintenance of similar to 90% rubella immunity among children. To evaluate whether rubella vaccination coverage among US preschool and school-age children is at levels consistent with rubella elimination, we reviewed data from 3 sources: (1) the Biologics Surveillance, which documents the net number of vaccine doses sold (1970-2004); (2) state immunization surveys of school entrants 5-6 years of age (1980-2005); and (3) the National Immunization Survey of children 19-35 months of age (1995-2004). Vaccine biologics data show that the net number of rubella vaccine doses sold was at least equivalent to the number of children born each year during 1970-2004. The average coverage for school-entrant surveys among reporting states was > 95% for 1980-2004. National coverage among children 19-35 months of age was >= 90% overall for each year during 1995-2004. Three independent surveys suggest that childhood coverage with rubella-containing vaccine has been at sufficiently high levels to achieve elimination of rubella virus transmission.