Rubella vaccination programmes aim to prevent congenital rubella infections. Previously differing programmes have now converged according to the following principle: First vaccination should be given at the age of 15 months (together with measles and mumps vaccine) to both boys and girls, in order to diminish the circulation of the wild virus. Teenage girls require (re-)vaccination to ensure their immunity. Also non-immune women have to be identified and vaccinated before they become pregnant. A low acceptance rate increases the risk of infection of pregnant women, independent of the vaccination omitted. As a rule natural and vaccine-induced immunity prevents congenital rubella infections. These infections are exceedingly rare in children born to immune mothers, and are always caused by the wild virus. This minimal risk will disappear only with the eradication of rubella virus, still a distant goal in countries offering vaccination only on a voluntary basis.