Rubella Vaccine's Effect Uncertain, Expert Says

Germán measles (rubella) vaccines "have been licensed for only a year and a half, and we don't know yet how effective fhey will be, ultimately," Dr. Dorothy M. Horstmann oí Yale University said here yesterday. She gave the fust annual Thomas Francis Jr. Memorial Lecture at the University's School of Public Health. The lecture is named in honor oí Dr Thomas Francis Jr., late professor in the U-M School o) Public Health and evaluator of Salk polio vaccine. "It is clear that we are ]us at the beginning of the task of controlling the disease by vac cination, and that as with poliomelitis and measles, many unsuspected problems no doub lie ahead," she said. Rubella, a major crippler o unborn infants through birth defects, "has turned out to be a wily virus- not unlike influenza in this respect- and there is no explaining some of its peculiar epidemiologie behavior. There s also still much to be learned about its nature and its antigenic composition." Dr. Horstmann said reinfection, for example, is possible after a person has had the disease or after immunization. Bu' it occurs more readily among the immunized than after natu ral infection. The "real dis ease" apparently confers a stronger immunity than do present vaccines. "It seems reasonable that current live virus vaccines might be improved upon, and a desirable goal is the development of effective noninfectious subunit vaccines which could be given safely to young women whether or not they are pregnant. Above all the situation today calis for long-term close follow up of the va'ccinated population," she said. "Part of the millions of 1 lars that have been voted by the Congress to immunize children of the nation would be wisely s p e n t in monitoring the results," Dr. Horstmann said. "The ultímate goal is the prevention of fetal rubella, and the success of all control measures must in the end be measured against the incidence of the rubella syndrome. "We can anticípate a natural decline in this problem in the United States in the next few years because of the high immunpty rate among young women now entering the childbearing age who were imtnunized as a result of infection during t'he 1964 epidemie," she I said. "Although it may be difficult for a while to evalúate the respective contributions o f I educing the problem, eventual-l y the pattern should becomel clear, and we should then learnl whether rubella is merely tem-l porarily down, or whether it is really out as a threat to future generations," Dr. Horstmann concluded. Dr. Horstmann is professor of epidemiology and public health at the Yale Medical School. She is a nationally recognized au- thority on viral diseases, hav-1 ing conducted extensive research on such diseases.