Reality don't care
In 1993 the MMR vaccine was withdrawn in Japan due to high rates of aseptic meningitis from the mumps component. This was followed in 1994 by removal of the vaccine requirements to attend school. The result? A marked increase vaccine-preventable illness. 11,991 cases of rubella in the first six months of 2013 with 10 cases of congenital rubella. 76% of cases were in the unvaccinated. For comparison:
2004–2012, 79 cases of rubella and six cases of CRS were reported in the United States; all of the cases were import-associated or from unknown sources.
Part of the reason the epidemic spread is that the Japanese only vaccinated females, so males have been a vector to allow the spread of disease. Not trying for herd immunity, they lost the ability to control the spread of infection. The only case of rubella I have seen was in 1999 when I visited a friend who lived in Tokyo who became ill with rubella the day I landed.
In 2007 to 2008 the Japanese had 27,000 cases of measles and they are trying to play catch-up with the vaccine. In 2012 the US had 222 cases of measles, 90% of which were imported and often occurred, like Texas, in communities with low or nonexistent vaccination rates.
Similar problems are occurring in Europe. There have been thousands of cases of measles, mumps and rubella that followed the decline in vaccination rates, with at least 78% of the measles cases in the unvaccinated.
Poland, Chile, Argentina, and Brazil, following the Japanese example of avoiding herd immunity, targeted only females for rubella vaccination and outbreaks continue in the male population, jumping to females with resultant cases of congenital rubella.
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