Contraindications

• History of anaphylactic reaction to neomycin or an anaphylactic reaction after a previous dose of rubella.
  
  
• Advanced immunodeficiencies e.g. congenital immune disorders, malignancies and immuno suppressive therapy.
  
  

Precautions

• Asymptomatic HIV positive persons can be immunized.
  
  
• Children with malignant disease or who have had a bone marrow transplant should be immunized against rubella six months after immunosuppressant treatment is stopped.
  
  
• Persons with active tuberculosis should not be vaccinated until treatment has been established.
  
  
• Persons who received blood products should wait at least 3 months before vaccination because rubella antibodies present in blood may interfere with vaccine. Blood products should be avoided for up to 2 weeks post vaccination.
  
  

Adverse events :- Are generally mild. Common symptoms are pain, redness and induration at the site of injection, low-grade fever, rash, lymphadenopathy, myalgia & parasthesia. Joint symptoms tend to be rare in children (0-3%) and in men, but are common among vaccinated adolescent & adult females. Anaphylactic reactions are rare.

Why is there a need for rubella vaccine?
The primary purpose of rubella vaccination is to prevent the occurrence of congenital rubella infection, which is an important cause of deafness, blindness and mental retardation in the child affected.

It is estimated that more than 100,000 cases of congenital rubella syndrome may occur each year in developing countries alone. Large-scale rubella vaccination during the last decade has drastically reduced or practically eliminated rubella and congenital rubella syndrome in many developed countries. Studies assuring cost-benefit of rubella vaccination have demonstrated that the benefits outweigh the costs and that rubella vaccination is economically justified, particularly when combined with measles vaccine.

WHO position on rubella vaccines :- WHO recommends the use of rubella vaccine in all countries with well-functioning childhood immunization programmes where reduction or elimination of congenital rubella syndrome is considered a public health priority. All countries undertaking rubella elimination should ensure that women of childbearing age are immune and that routine coverage in children is sustained at over 80%.

Two approaches are recommended :-

• WHO recommends the use of rubella vaccine in all countries with well-functioning childhood immunization programmes where reduction or elimination of congenital rubella syndrome is considered a public health priority. All countries undertaking rubella elimination should ensure that women of childbearing age are immune and that routine coverage in children is sustained at over 80%.
  
  
• Elimination of rubella as well as congenital rubella syndrome through universal immunization of infants. Surveillance and assuring immunity in women of childbearing age.
  
  

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11. Core information for the development of Immunization Policy. WHO- Vaccines and Biologicals. 2002 Update