A Review on Rubella Vaccine: Iran (1975-2019)

The first Attenuated rubella vaccine was developed by Parkman and Meyer in 1966. Ten years later in the 1975s, the rubella vaccine was developed in Razi Vaccine and serum research institute) RVSRI). In 1977, the rubella TAKAHASHI vaccine successfully passed the clinical trial and was initially used voluntarily only in the private sector. Since 1987, the administration of rubella as MMR (Measles/AIK-C; Rubella/TAKAHASHI; Mumps/HOSHINO) strain vaccine has been included in the immunization program in Iran. This review article focused on the development and production of the rubella TAKAHASHI/HDC vaccine in RVSRI. The herd immunity and rubella cases were investigated in the pre- and post-vaccine era. The effectiveness and proper coverage of the rubella vaccine led to the elimination of rubella from Iran in 2019. The current study aimed to assess local rubella vaccine manufacturing and its consequences on rubella elimination from Iran, using various search engines. A complete search was carried out in medical databases, including PubMed, Scopus, Web of Science, Scientific Information Database, IranMedex, Magiran, and Google Scholar. Within 1972-1975, Rubella TAKAHASHI/HDC vaccine was developed by RVSRI and successfully passed clinical trial in 1977. Over the four last decades (1980-2020), more than 40 million infants, young, and adults were vaccinated by million doses of local Rubella, measles-rubella (MR) or measles-mumps-rubella (MMR) vaccine in Iran. In 1972, the pre-vaccine era, the overall sensitivity to rubella infection was 69% in one-year-old Iranian children and 23% in childbearing women. The use of a safe, inexpensive, and effective vaccine increased herd immunity to 95% (85%-99%) in our country. During the last two decades, we have witnessed a 91% decline in the confirmed rubella cases, from 1124 in 2000 to 33 cases in 2018. The current article presented the process of vaccine development, tracked it through more than four decades, and discussed disease status before and after the rubella vaccine era, as well as the history of its elimination from Iran. The effectiveness of the local Razi Rubella vaccine resulted in a significant increase in seroprevalence in Iran. Expanded vaccination against rubella, usually with measles, has led to the elimination of Rubella from Iran as confirmed by World Health Organization in 2019.