TY - JOUR AU - Mizumoto, Kenji AU - Chowell, Gerardo T1 - Temporary Fertility Decline after Large Rubella Outbreak, Japan T2 - Emerging Infectious Disease journal PY - 2020 VL - 26 IS - 6 SP - 1122 SN - 1080-6059 AB - Japan experienced 2 large rubella epidemics in 2004 and 2012–2014. Because of suboptimal immunization levels, the country has been experiencing a third major outbreak during 2018–2020. We conducted time series analyses to evaluate the effect of the 2012–2014 nationwide rubella epidemic on prefecture-level natality in Japan. We identified a statistically significant decline in fertility rates associated with rubella epidemic activity and increased Google searches for the term “rubella.” We noted that the timing of fertility declines in 2014 occurred 9–13 months after peak rubella incidence months in 2013 in 4 prefectures with the highest rubella incidence. Public health interventions should focus on enhancing vaccination campaigns against rubella, not only to protect pregnant women from infection but also to mitigate declines in population size and birth rates. KW - rubella KW - vaccine-preventable diseases KW - outbreak KW - time series KW - birth risk KW - viruses KW - Japan KW - rubella virus KW - fushin KW - German measles KW - fertility KW - congenital rubella syndrome KW - CRS KW - miscarriage KW - stillbirth KW - birth defects DO - 10.3201/eid2606.181718 UR - https://wwwnc.cdc.gov/eid/article/26/6/18-1718_article ER - End of Reference