**Question:** All of the following statements about congenital rubella are true except ?

A. Rubella is a viral infection that affects pregnant women, resulting in congenital rubella syndrome in their offspring.
B. The primary mode of transmission for rubella is through airborne respiratory droplets.
C. Congenital rubella syndrome primarily affects the eyes and ears of the affected infant.
D. Vaccination against rubella is available and highly effective in preventing rubella infection.

**Core Concept:** Congenital rubella syndrome (CRS) is a group of severe birth defects caused by maternal rubella infection during pregnancy. The rubella virus crosses the placenta and infects the fetus, leading to CRS. Rubella is transmitted through respiratory droplets from an infected person. Vaccination is an effective measure to prevent rubella infection.

**Why the Correct Answer is Right:**

The correct answer is **D** because vaccination against rubella is true and highly effective in preventing rubella infection. Rubella vaccination is a crucial measure to protect pregnant women and prevent congenital rubella syndrome in their offspring. Rubella can be transmitted via respiratory droplets, and while these facts are true, the correct answer focuses on vaccination, which is the exception in the given statements.

**Why Each Wrong Option is Incorrect:**

A) Although rubella does infect pregnant women and cause congenital rubella syndrome in their offspring, this option is incorrect because it does not focus on the exception mentioned in the question (vaccination).

B) While rubella can be transmitted through respiratory droplets, this option is incorrect because it does not address the exception mentioned in the question (vaccination).

C) While congenital rubella syndrome can affect various organs, particularly eyes and ears, this option is incorrect because it does not address the exception mentioned in the question (vaccination).

**Clinical Pearls:**

1. Rubella remains a significant global health concern, as it causes severe congenital birth defects when contracted during pregnancy.
2. Pregnant women should receive the rubella vaccine to protect both the mother and the fetus from infection. Vaccination is a crucial preventive measure against congenital rubella syndrome.
3. Rubella vaccination is part of the Expanded Program on Immunization (EPI) in many countries, providing a robust public health strategy to control rubella transmission and its consequences, such as CRS.