Our findings suggest that SIAs among adolescents would most effectively reduce congenital rubella syndrome as well as eliminate rubella, owing both to fewer infections in the immunised population and absence of infections that those immunised would otherwise have caused. Metapopulation models with realistic mixing are uniquely capable of assessing such indirect effects.

Rubella is a highly contagious disease with most patients presenting only mild febrile rash symptoms, yet rubella infections during pregnancy can cause miscarriage, stillbirths, and other severe birth defects known as congenital rubella syndrome. To prevent rubella transmission and congenital rubella syndrome, vaccination with rubella-containing vaccine, routine immunisation and supplementary…