How nepal eliminated rubella
| Intervention | Details |
|---|---|
| Vaccine introduction | Rubella vaccine (combined or part of MR) introduced in 2012; second dose added in routine immunization in 2016. (World Health Organization) |
| Periodic immunization campaigns | Campaigns in 2012, 2016, 2020, and 2024 helped raise coverage. (World Health Organization) |
| High vaccine coverage | By 2024, over 95% of children got at least one dose of rubella vaccine. (World Health Organization) |
| Surveillance & lab system | Strengthened disease surveillance (case-based), congenital rubella syndrome monitoring, lab algorithms. (World Health Organization) |
1.Definition
Rubella elimination = Interruption of endemic rubella virus transmission in a defined geographic area for ≥12 months, with a high-quality surveillance system in place.
It is not eradication (disease can still be imported).
2. Background
Rubella causes mild illness but is dangerous in pregnancy → congenital rubella syndrome (CRS).
Globally, WHO SEAR (South-East Asia Region) aimed for rubella elimination by 2023.
Nepal achieved verification of rubella elimination in August 2025 (WHO announcement).
3. Key Interventions
Nepal used a multi-pronged epidemiological strategy:
a. Vaccine introduction & expansion
Rubella-containing vaccine introduced in 2012 as part of national immunization schedule.
Second dose added in 2016 for stronger immunity.
**b. Mass immunization campaigns
Nationwide rubella / measles–rubella (MR) campaigns in 2012, 2016, 2020, 2024.
Campaigns targeted children 9 months–15 years, closing immunity gaps.
c. High coverage achieved
Routine immunization coverage consistently >95% by 2024.
Two-dose MR coverage expanded across all provinces.
d. Strong surveillance system
Case-based measles-rubella surveillance integrated with EWARS.
Laboratory confirmation of suspected cases via national reference labs.
Congenital Rubella Syndrome (CRS) surveillance established.
e. Outbreak investigation & rapid response
Any suspected outbreaks (clusters of fever & rash) investigated quickly with lab support.
Outbreak response immunization where needed.
f. Verification process
National Verification Committee (NVC) compiled evidence: vaccination data, epidemiological trends, surveillance quality indicators.
WHO Regional Verification Commission confirmed elimination status (Aug 2025).
4. Results / Outcome
Nepal verified rubella elimination on 18 August 2025.
Transmission of endemic rubella virus interrupted; CRS cases reduced significantly.
5. Conclusion & Future Implications
Nepal’s success shows strong immunization + surveillance can eliminate vaccine-preventable diseases.
However, continued MR vaccination and surveillance are essential to prevent re-introduction from imported cases.
Next goal: Measles elimination by 2026.