From the Guidelines
Rubella vaccination should not be given during pregnancy due to the theoretical risk of transmitting the virus to the developing fetus. The rubella vaccine is a live attenuated virus vaccine, and although no cases of congenital rubella syndrome have been documented from vaccine administration during pregnancy 1, it is still recommended to avoid vaccination during pregnancy. Pregnant women who receive the vaccine should be counseled about the theoretical risks to the fetus. Women should avoid becoming pregnant for at least 28 days after receiving the rubella vaccine. If a woman is found to be pregnant after receiving the vaccine, this is not typically considered a reason to terminate the pregnancy 1. Instead, the situation should be discussed with her healthcare provider.
Key Considerations
- Theoretical risk of transmitting the virus to the developing fetus
- No cases of congenital rubella syndrome have been documented from vaccine administration during pregnancy
- Women should avoid becoming pregnant for at least 28 days after receiving the rubella vaccine
- Vaccination during pregnancy is not typically considered a reason to terminate the pregnancy
Recommendations
- Avoid rubella vaccination during pregnancy
- Counsel pregnant women who receive the vaccine about the theoretical risks to the fetus
- Recommend vaccination in the immediate postpartum period before hospital discharge to protect against infection in future pregnancies 1
From the Research
Rubella Vaccination in Pregnancy
- The use of live attenuated virus in rubella vaccine is contraindicated during pregnancy 2, 3, 4.
- However, studies have shown that the risk of congenital rubella syndrome (CRS) following rubella vaccination during pregnancy is theoretical, and no cases of CRS have been reported in most studies 3, 5.
- One case of congenital rubella syndrome has been reported following measles-mumps-rubella vaccination during pregnancy 2.
- The maximum theoretical risk for CRS following rubella vaccination of susceptible pregnant women was estimated to be 0.2% 3 or 1 case in 1008 vaccinated women 5.
- Asymptomatic rubella vaccine virus infection of the neonate can occur, with an estimated risk of 1.74% 5.
- Inadvertent vaccination during pregnancy is not an indication for termination of pregnancy, as the risk/benefit balance is in favor of vaccination 5.
- The safety of rubella-containing vaccines has been confirmed in several studies, with no severe adverse events reported in pregnant women who were inadvertently vaccinated 6.