all of the cases have been linked to rubella. health authorities say rubella is spreading across the country. the number of patients in the first 11 weeks of this year is nearly 22 times higher compared to the same period last year. many of them are in their 20s to 40s. currently, a fully funded program allows children to get two shots before entering elementary school. but back when japanese in their 20s to 40s were children, the vaccination was either optional or only for girls. the concern is these adults who are at risk of catching rubella are of child bearing age. and so their children could be at risk too. health officials are doing more to put out the information on the risks posed by rubella. but getting the people to sign up if they need the vaccination and pay for it is still tough. the response has been low. adults must pay around $50 to $100 for each shot. some local governments started covering part of the cost. but they require documentation and the number of clinics is limited. infectious disease specialists say th