Tischer A, Gerike E (2000): Rötelnsituation in Deutschland. Ergebnisse der seroepidemiologischen Überwachung von 1990 bis 1998. [Rubella in Germany: Results of the seroepidemiological surveillance from 1990-1998]
Bundesgesundheitsbl 43 (12): 1-10.

The present situation regarding rubella is reflected in seroprevalence studies performed between 1990 and 1998. By selective immunisation of girls and young women (the female population >13 years of age) it was possible to a wide extent to close immunity gaps in young adults which occurred in the pre-vaccination era. In 1998 in the cohort of the 18-30-year-old population only 0.8-3% of the women were seronegative for rubella, compared to 5-13% of the men. Differences regarding immunity between old and new federal Länder are no longer existent, although vaccination against rubella was only introduced in the new Länder after the reunification. Above all, a potential risk for pregnant women without protection against rubella is conferred by the high percentage of pre-school children without rubella immunity. This is due to the delay in starting to vaccinate small children, but also to a lower acceptance of the combined vaccination. Compared to countries like Finland, Sweden or the United States, which have almost achieved the elimination of congenital rubella syndrome (CRS), in Germany a considerable number of individuals remain susceptible to this infection. Continuous endemic virus circulation endangers the main target group of rubella vaccination, i. e. women in the early stages of pregnancy. Only when MMR vaccination rates of more than 90% are achieved in small children in the course of their second year of life, there will be a real chance in Germany to eradicate not only measles, but also the CRS over the next 10 years.