When there is a low level of childhood immunization in a population it is possible for rates of congenital rubella to increase as more women make it to child-bearing age without either vaccination or exposure to the disease.

The first is initially efforts to immunize all people less than forty years old followed by providing a first dose of vaccine between 9 and 12 months of age.

[1] Women who are planning to become pregnant are recommended to have rubella immunity beforehand, as the virus has a potential to cause miscarriage or serious birth defects.

[5] Immunity may be verified by pre-pregnancy blood test, and it is recommended that those with negative results should refrain from getting pregnant for at least a month after receiving the vaccine.

[6] Since the 1962–1965 rubella epidemic that swept Europe in 1962-1963 and the US in 1964–1965, several efforts were made to develop effective vaccines using attenuated viral strains, both in US and abroad.

[7] The first successful strain to be used was the HPV-77, prepared by passing the virus through the cells of an African green monkey kidney 77 times.

The efforts to develop the vaccine were conducted by a team of researchers at the National Institutes of Health's Division of Biologics Standards.

Prior to arriving at the National Institutes of Health (NIH), Parkman had been working on isolating the rubella virus for the Army.

[9] Parkman, Meyer, and the team from the NIH tested the vaccine at the Children's Colony in Conway, Arkansas in 1965 while a rubella epidemic still raged across the United States.

[9] In June 1969, the NIH issued the first license for commercial production of the rubella vaccine to the pharmaceutical company Merck Sharp & Dohme.

The vaccine was attenuated and prepared in the WI-38 normal human diploid cell strain which was developed by Hayflick[14][15] and gifted to Plotkin by him.