Rubella immunization is intended to prevent fetal infection and consequent congenital rubella syndrome, which can occur in up to 80% of fetuses of mothers infected during the first trimester of pregnancy. The number of reported cases of rubella in the United States has decreased steadily from more than 56,000 in 1969, the year the rubella vaccine was licensed, to 10 cases in 2005. Rubella was declared eliminated from the United States in 2004, and from the Americas in 2010, although rare outbreaks still occur elsewhere in the world.
Rubella vaccine is recommended for adults, particularly women, unless proof of immunity is available (documented rubella vaccination on or after the first birthday or a positive serologic test result) or the vaccine is specifically contraindicated. A single subcutaneously administered dose of live, attenuated rubella vaccine provides long-term (probably lifetime) immunity in approximately 95% of persons vaccinated. Because of the theoretical risk to the fetus, women of childbearing age should receive the vaccine only if they are not pregnant.
Excerpted from BCSC 2020-2021 series: Section 1 - Update on General Medicine. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.