Measles-Rubella Vaccination: Epidemiological Issue, Immunology, and Ethical Challenges
Keywords:
Measles-Rubella, Vaccination, Epidemiology, Immunology, Ethic
Abstract
This article discusses issues related to measles-rubella vaccination from the perspective of epidemiology, immunology, and ethical challenges faced. Measles and rubella are infectious diseases that have the potential to cause extraordinary events (KLB) throughout the world, including Indonesia. Although measles-rubella vaccination has been proven effective in reducing the incidence of the disease, challenges such as low vaccination coverage due to the COVID-19 pandemic, vaccine hesitancy, and ethical issues related to parental consent and equal access to vaccines are significant obstacles. Research shows that to achieve effective community immunity, a vaccination coverage of at least 95% is required. This article also describes the immunological processes involved in the response to measles and rubella infection and the importance of public health efforts in increasing awareness and access to vaccines. With a comprehensive and inclusive approach, it is hoped that existing challenges can be overcome and community participation in vaccination programs can be increased. Collaboration between the government, health institutions, and the community is essential to create a healthier and safer environment, ultimately supporting the goal of eliminating measles and rubella in the future.
References
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Vynnycky, E., Knapp, J. K., Papadopoulos, T., Cutts, F. T., Hachiya, M., Miyano, S., & Reef, S. E. (2023). Estimates of the global burden of Congenital Rubella Syndrome, 1996-2019. International Journal of Infectious Diseases, 137, 149–156. https://doi.org/10.1016/j.ijid.2023.09.003
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Andrus, J. K., Cochi, S. L., Cooper, L. Z., & Klein, J. D. (2016). Combining global elimination of measles and rubella with strengthening of health systems in developing countries. Health Affairs, 35(2). https://doi.org/10.1377/hlthaff.2015.1005
Avota, E., Gassert, E., & Schneider-Schaulies, S. (2010). Measles virus-induced immunosuppression: from effectors to mechanisms. Medical Microbiology and Immunology, 199(3), 227–237. https://doi.org/10.1007/s00430-010-0152-3
Barakat, M., Abdaljaleel, M., Atawneh, N., Alkhazaleh, R., Aburumman, D., Hamed, E., & Sallam, M. (2023). Pervasive Parental Hesitancy and Resistance towards Measles Rubella Vaccination in Jordan. Vaccines, 11(11), 1672. https://doi.org/10.3390/vaccines11111672
Chaklader, B., Banerjee, A., Rathod, H., Srivastava, K., Lakhute, S., & Borgaonkar, C. (2023). Measles Rubella Vaccination Campaign: Pandemic as Speed Breaker. Medical Journal of Dr. D.Y. Patil Vidyapeeth, 16(4). https://doi.org/10.4103/mjdrdypu.mjdrdypu_868_21
Coulborn, R. M., Danet, C., & Alsalhani, A. (2024). Measles and rubella vaccine microneedle patch: new hope to reach the unreached children. The Lancet, 403(10439), 1825–1827. https://doi.org/10.1016/S0140-6736(24)00749-9
Cutts, F. T., Lessler, J., & Metcalf, C. J. E. (2013). Measles elimination: Progress, challenges and implications for rubella control. In Expert Review of Vaccines (Vol. 12, Issue 8). https://doi.org/10.1586/14760584.2013.814847
Emanuel, E. J., & Persad, G. (2023). The shared ethical framework to allocate scarce medical resources: a lesson from COVID-19. In The Lancet (Vol. 401, Issue 10391). https://doi.org/10.1016/S0140-6736(23)00812-7
Gong, X., Zheng, C., Fang, Q., Xu, W., & Yin, Z. (2024). A case of congenital rubella syndrome and epidemiology of related cases in China, 2014–2023. Human Vaccines & Immunotherapeutics, 20(1). https://doi.org/10.1080/21645515.2024.2334917
Grant, G. B., & Zimmerman, L. (2023). Decreases in Congenital Rubella Syndrome Reflect Concerted Efforts Toward Rubella and Measles Elimination. In International Journal of Infectious Diseases (Vol. 137). https://doi.org/10.1016/j.ijid.2023.10.012
Haralambieva, I. H., Gibson, M. J., Kennedy, R. B., Ovsyannikova, I. G., Warner, N. D., Grill, D. E., & Poland, G. A. (2017). Characterization of rubella-specific humoral immunity following two doses of MMR vaccine using proteome microarray technology. PLOS ONE, 12(11), e0188149. https://doi.org/10.1371/journal.pone.0188149
Higgins, D. M., & O’Leary, S. T. (2024). A World without Measles and Rubella: Addressing the Challenge of Vaccine Hesitancy. Vaccines, 12(6), 694. https://doi.org/10.3390/vaccines12060694
Luyten, J., Vandevelde, A., Van Damme, P., & Beutels, P. (2011). Vaccination policy and ethical challenges posed by herd immunity, suboptimal uptake and subgroup targeting. Public Health Ethics, 4(3). https://doi.org/10.1093/phe/phr032
Marckmann, G. (2021). Ethical Aspects of Vaccination. VacciTUTOR. https://doi.org/10.33442/vt202127
McGinley, B. N., & Sakharkar, P. (2023). Investigation of MMR Vaccination Rates and its Relationship with Measles, Mumps, and Rubella Outbreaks in California. ASPET 2023 Annual Meeting Abstract - Pharmacogenomics and Translational Pharmacology, 431. https://doi.org/10.1124/jpet.122.232460
Ortiz-Millán, G. (2024). Ethical and Practical Considerations for an Agreement to Ensure Equitable Vaccine Access Comment on “More Pain, More Gain! The Delivery of COVID-19 Vaccines and the Pharmaceutical Industry’s Role in Widening the Access Gap.” International Journal of Health Policy and Management, 13, 8516. https://doi.org/10.34172/ijhpm.2024.8516
Owen Schaefer, G. (2023). Fairly and Pragmatically Prioritizing Global Allocation of Scarce Vaccines during a Pandemic. In Pandemic Ethics (pp. 231–247). Oxford University PressOxford. https://doi.org/10.1093/oso/9780192871688.003.0012
Plotkin, S. A. (2021). Rubella Eradication: Not Yet Accomplished, but Entirely Feasible. The Journal of Infectious Diseases, 224(Supplement_4), S360–S366. https://doi.org/10.1093/infdis/jiaa530
Reiss, D. R., & Karako-Eyal, N. (2019). Informed Consent to Vaccination: Theoretical, Legal, and Empirical Insights. SSRN Electronic Journal. https://doi.org/10.2139/ssrn.3319395
Rudolph, M. E., McArthur, M. A., Magder, L. S., Barnes, R. S., Chen, W. H., & Sztein, M. B. (2019). Characteristics of regulatory T-cell populations before and after Ty21a typhoid vaccination in children and adults. Clinical Immunology, 203, 14–22. https://doi.org/10.1016/j.clim.2019.04.002
Shi, X. (2024). Deep Reinforcement Learning (DRL) Is Used to Optimize Vaccination Strategies and Resource Allocation. Highlights in Science, Engineering and Technology, 102, 833–842. https://doi.org/10.54097/see7fa88
Sodjinou, V. D., Nimpa, M. M., Douba, A., Masembe, Y. V., Randria, M., & Ndiaye, C. F. (2020). Challenges related to resources mobilization for measles outbreak response: Madagascar experience during the 2018-2019 measles outbreak. Pan African Medical Journal, 36. https://doi.org/10.11604/pamj.2020.36.304.24514
Steele, D., & Duthie, K. (2021). Ethics of resource allocation in a public health emergency context. Healthcare Management Forum, 34(6). https://doi.org/10.1177/08404704211047911
Strebel, P., Grabowsky, M., Hoekstra, E., Gay, A., & Cochi, S. (2024). Evolution and Contribution of a Global Partnership against Measles and Rubella, 2001–2023. Vaccines, 12(6), 693. https://doi.org/10.3390/vaccines12060693
Tarmizi, S. N. (2023, May 2). Suntikan Imunisasi Ganda untuk Cegah Campak. Kemkes.Go.Id. https://www.kemkes.go.id/id/rilis-kesehatan/suntikan-imunisasi-ganda-untuk-cegah-campak
Thompson, K. M. (2024). The Health and Economic Benefits of United States Investments in Measles and Rubella Control and Elimination. Vaccines, 12(11). https://doi.org/10.3390/vaccines12111210
Valenzuela-Almada, M. O., Michel-Izeta, B. E., & Derive, S. (2020). Is keeping my child from getting the MMR vaccine unethical? Bioethical arguments for informed decision-making. Bioethics Update, 6(2), 121–138. https://doi.org/10.1016/j.bioet.2020.03.002
Vynnycky, E., Knapp, J. K., Papadopoulos, T., Cutts, F. T., Hachiya, M., Miyano, S., & Reef, S. E. (2023). Estimates of the global burden of Congenital Rubella Syndrome, 1996-2019. International Journal of Infectious Diseases, 137, 149–156. https://doi.org/10.1016/j.ijid.2023.09.003
WHO. (2024, May 14). Rubella. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/rubella
Zagaja, A., Patryn, R., Pawlikowski, J., & Sak, J. (2018). Informed Consent in Obligatory Vaccinations? Medical Science Monitor, 24, 8506–8509. https://doi.org/10.12659/MSM.910393
Published
2025-01-24
How to Cite
Ainurafiq, A., Asrianti, T., Sartika, S., Salim, E. S., & Indar, I. (2025). Measles-Rubella Vaccination: Epidemiological Issue, Immunology, and Ethical Challenges. ancasakti ournal f ublic ealth cience nd esearch, 5(1), 43-53. https://doi.org/10.47650/pjphsr.v5i1.1641
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Articles
Copyright (c) 2025 Ainurafiq Ainurafiq, Tanti Asrianti, Sartika Sartika, Eman Salim Ahmed Salim, Indar Indar
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