The epidemiology of rubella was modified by generalization of vaccination. A monovalent (anti-Rubella) vaccine was originally used. After 1970, the trivalent vaccine ROR/MMR (Measles-mumps-rubella/Measles-Mumps-Rubella) was also in use. Before the introduction of vaccination the disease evolves in the form of relatively frequent cyclical epidemics.
Extensive epidemics occurred every 20-30 years. In the course of this epidemics was possible to be observed and analyzed cases of congenital malformations in newborns from infected mothers with rubella during pregnancy. Thus, information on congenital rubella was accumulated (e.g. in the epidemics of 1964-1965 in the US and 1978 in the UK).
It is estimated that annually, 110,000 children are affected by Congenital rubella syndrome (CRS). Between 2002-2003 Romania faced a rubella epidemic totaling 115,000 cases (incidence of 531 cases in 100,000 inhabitants). There were suspected 150 cases of congenital rubella and seven were confirmed. In 2011-2012 Romania faced a new rubella epidemic that affected over 20,000 people.