Population-based study of a free rubella-specific antibody testing and immunization campaign in Chiba city in response to the 2018–2019 nationwide rubella outbreak in Japan

Japan has not been able to eliminate rubella; as a result, the large rubella epidemic has occurred. Considering the complicated history of the vaccine policy in Japan, some susceptible populations became infected with rubella, resulting in an outbreak. We conducted a large serosurveillance against rubella in Chiba city after initiating free rubella-specific antibody testing and an immunization campaign during 2018–2019. The total number of rubella specific antibody tests that was conducted in the nationwide campaign and Chiba city original campaign was 8277 and 6104, respectively. The proportion of participants with an antibody titer of ≤1:16 using the hemagglutination inhibition (HI) test was higher in those in their 20–30s. On the contrary, the proportion of participants with an antibody titer of <1:8 using the HI test was higher in men in their 40–50s. This discrepancy possibly reflects the complicated history of the vaccine policy. The number of participants in the nationwide immunization campaign in this city was 1517, whereas that in the Chiba city campaign was 3607. The Chiba city campaign was effective against women in their 20–30s (child-bearing generation); however, the nationwide campaign was not sufficiently effective against men in their 40–50s because many workers were did not visit medical facilities to receive the measles–rubella vaccine