Changes in Rubella Vaccine Recommendations for Women Trying to Conceive

What are the newest recommendations about getting the rubella vaccine while trying to conceive?

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Health care providers are now being advised that it is safe for women to receive their rubella vaccination up to one month before becoming pregnant instead of the previous three-month waiting period, according to an opinion released November 2002 by the American College of Obstetricians and Gynecologists (ACOG). Women who have just given birth and are at high risk for acquiring rubella should be vaccinated before they leave the hospital.

Rubella, also known as German measles, is an infectious viral disease that if acquired during pregnancy can cause blindness, heart defects, deafness and other birth defects in the newborn. The risk to the fetus depends on the stage of pregnancy at the time the woman is infected. If infection occurs during the first month of pregnancy, the fetus has a 50 percent chance of being affected. The risk drops to 10 percent by the third month.

Rubella immunization is typically given along with the mumps and measles vaccines. Ideally, women who are not immunized or haven't already had rubella should be vaccinated before they become pregnant or immediately postpartum before they leave the hospital.

If the vaccine is inadvertently given early in pregnancy, the risk to the fetus is very low and is not reason enough to terminate the pregnancy, says ACOG. According to the new opinion, rubella vaccination is believed to be safe for women who are breastfeeding.

Although the overall incidence of rubella infection has decreased in the U.S. over the past decade, there have been cluster outbreaks of the disease, especially among people born outside of the U.S. Most Americans born after 1969 have been vaccinated against rubella and approximately 75 to 80 percent retain immunity to the disease, but because of the high risk of birth defects, pregnant women are routinely screened for antibodies to the virus.

Source: American College of Obstetricians and Gynecologists Press Release, November 29, 2002

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