From the Guidelines
Repeat vaccination for rubella is indicated if both IgG and IgM antibody levels are low, as a low rubella IgG level indicates lack of immunity, either from previous vaccination failure or waning immunity over time. According to the most recent and highest quality study available, persons can be considered immune to rubella only if they have documentation of laboratory evidence of rubella immunity or adequate immunization with at least one dose of rubella vaccine on or after the first birthday 1. The MMR (measles, mumps, rubella) vaccine is recommended for adults without evidence of immunity, with a single dose being sufficient for most individuals. Key groups that should prioritize vaccination if not immune include:
- Healthcare workers
- College students
- Women planning pregnancy The vaccine is contraindicated during pregnancy but should be given to non-immune women immediately postpartum. After vaccination, antibody levels typically rise within 2-4 weeks, providing long-lasting protection 1. Vaccination is important not only for personal protection against rubella infection but also to prevent congenital rubella syndrome in babies born to infected mothers during pregnancy. No serologic testing is needed after vaccination, as the response rate to the rubella component of MMR is approximately 95%.
From the Research
Rubella Immunoglobulin G (IgG) and Immunoglobulin M (IgM) Levels
- Low levels of Rubella IgG and IgM may indicate a lack of protection against Rubella infection 2, 3, 4
- Studies have shown that a third dose of measles-mumps-rubella (MMR) vaccine can boost antibody titers and provide protection against Rubella infection 2, 5
Repeat Vaccination Indication
- Repeat vaccination may be indicated if Rubella IgG and IgM levels are low, as it can help boost antibody titers and provide protection against Rubella infection 2, 5
- However, the decision to administer a third dose of MMR vaccine should be made on a case-by-case basis, taking into account individual factors such as vaccination history and risk of exposure to Rubella virus 5, 3
Factors Affecting Immunity
- The duration of immunity after MMR vaccination can vary depending on several factors, including the age at vaccination, the number of doses received, and individual immune responses 5, 3
- Studies have shown that immunity to Rubella can wane over time, especially in individuals who received their last dose of MMR vaccine at a young age 3, 4
Diagnostic Tests
- Enzyme-linked immunosorbent assay (ELISA) and rapid immunochromatographic tests are commonly used to diagnose Rubella infection and assess immunity 4, 6
- However, these tests may have limitations in terms of sensitivity and specificity, and results should be interpreted in the context of clinical symptoms and vaccination history 4, 6