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Some women in Japan have contracted rubella during the early stages of pregnancies, resulting in birth defects in 31 cases, even though they had received vaccinations against the virus during childhood, researchers said Monday.

The findings suggest the protection provided by the vaccination wore off with age and that people should be immunized twice, once in early childhood and again in early adulthood, according to Shigetaka Kato, a member of the research group who also works for the U.S. Centers for Disease Control and Prevention.

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