Measles-rubella vaccine support

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Doubling impact in a single shot, Gavi’s support for measles-rubella vaccine is a game changer in the control of two deadly and debilitating diseases

Measles-rubella Tanzania

In 2014 Tanzania launched a nationwide immunisation campaign supported by Gavi to protect 21 million children against measles and rubella. Credit: Gavi/2014/Karel Prinsloo.

In line with WHO recommendations, Gavi is providing support for large-scale catch-up campaigns with the measles‑rubella (MR) vaccine, on the basis that countries then self-finance the introduction of the vaccine into their routine immunisation programmes.

This is a major step in accelerating global progress in the control of two life-threatening diseases.

By the end of 2014, 140 million children between 9 months and 14 years of age had been immunised with measles-rubella vaccine with Gavi support.

Gavi’s support for rubella is a game changer in the control of a disease that causes serious, life-long disabilities in infants.  

Dr Susan Reef, Medical Epidemiologist, Centers for Disease Control and Prevention

The largest Gavi supported MR campaign to date was in Bangladesh in January 2014. More than 53 million boys and girls aged between 9 months and 14 years were vaccinated in a single nationwide campaign.

Rubella infection just before conception or in early pregnancy can result in foetal death or birth defects due to congenital rubella syndrome

Measles remains one of the top vaccine-preventable killers of children

Rubella is no longer the threat it once was in many countries, thanks to widespread vaccination. But for millions of mothers and their children in developing countries, the disease poses an on-going danger. According to WHO, more than 100,000 babies are born with congenital rubella syndrome each year – the majority in Africa and South-East Asia. Although rubella vaccine has been available since the 1970s, it is still underused in these regions.

Measles, a highly contagious and deadly disease, remains one of the top vaccine-preventable killers of children. Thanks to the widespread introduction of measles vaccine, global measles deaths have fallen dramatically. However, progress has stalled and outbreaks continue in Africa and Europe.


Rubella usually affects children and young adults and is considered a mild illness, except in pregnant women. When a woman is infected with the rubella virus early in pregnancy, she has a 90% risk of passing the virus on to her foetus. This can cause miscarriage, stillbirth or severe birth defects known as congenital rubella syndrome (CRS).

Africa and Southeast Asia have the highest number of estimated CRS cases and the lowest uptake of rubella-containing vaccine. In 2015 more than 30 Gavi-supported countries, mostly in Africa, were not using rubella vaccine in their national immunisation schedules.

Before 2001, more than 750,000 children died every year from measles, whose symptoms include high fever and a severe skin rash.

Global measles deaths fell by 75% from an estimated 562,000 in 2000 to 145,700 in 2013. This was largely helped by the Measles & Rubella Initiative, a global partnership committed to ensuring no child dies from measles or is born with congenital rubella syndrome. However, measles remains a pressing public health issue, which kills an estimated 400 people every day.

Gavi’s support for rubella – an underused vaccine – in combination with measles vaccine, benefits women’s and children’s health

The combined measles-rubella vaccine provides a 2-in-1 shot against two devastating diseases


Rubella vaccine gives long-term protection. It is often given in combination with measles vaccine – an effective, safe and cost-effective tool to prevent measles morbidity and mortality – in the form of measles‑rubella (MR) or measles‑mumps‑rubella vaccine.

WHO guidelines in 2011 supported a paradigm shift in vaccination strategy for the introduction of rubella-containing vaccines. Earlier thinking in the rubella disease community placed an emphasis on immunising adolescent girls and women of child-bearing age to decrease the risk of CRS. However, in many settings women were difficult to access resulting in limited vaccine coverage, and the rubella virus continued to circulate.

When routine childhood immunisation coverage is low, rubella continues to spread and children remain susceptible into adulthood. The new approach uses wide-age-range immunisation campaigns to interrupt transmission of the rubella virus, followed by rapid introduction of the vaccine into the routine immunisation system. The aim is to eliminate rubella and CRS over the long term.


The measles-rubella (MR) vaccine marks the first time Gavi is addressing the two diseases simultaneously, and builds on efforts by the Measles & Rubella Initiative.

Gavi is investing more than US$ 600 million in the fight against measles-rubella through large-scale catch-up campaigns targeting children under 15 years of age. The campaigns aim to catalyse countries to self-finance the introduction of measles-rubella vaccine into their routine immunisation programmes.

The campaigns target children aged 9 months to 14 years and ensure sustainability by embedding MR vaccine into the routine system. This catalytic support will have a sustainable and positive impact on both rubella and measles control efforts.

Gavi’s investment in measles-rubella vaccine builds on its earlier support of US$ 176 million to the Measles Initiative for measles campaigns, and Gavi’s support to countries for introduction of a second dose of measles vaccine into routine immunisation programmes.

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