Some recipients shed small amounts of virus intermittently from the pharynx between seven and 28 days after vaccination, but there is no evidence that vaccine virus is transmissible, and household contacts of recipients, even pregnant women, are not at risk. By 1982, more than 118 million doses of rubella vaccine had been distributed in the United States, with very few serious adverse effects. Arthralgia occurs in up to three percent of children after vaccination, but arthritis is rare. In contrast, arthralgia develops in up to 40 percent of adults who receive the vaccine, and arthritis develops in up to 15 percent of vaccinated adults. Paresthesia and limb pain are much less common.
Chronic arthropathy is very rare.
Adolescent and adult females should not receive rubella vaccine unless they can avoid pregnancy for at least three months after vaccination. As of 1987, the CDC had received reports of 1,176 women given rubella vaccine within three months of conception. More important, congenital rubella syndrome has not been recognized in the children of mothers who received rubella vaccine during pregnancy. The ACIP believes that the risk of congenital rubella syndrome caused by rubella vaccine virus is so small as to be negligible and that rubella vaccination during pregnancy or within three months before conception is not ordinarily a reason to interrupt the pregnancy. The ACIP points out that pregnancy is a contraindication to rubella vaccination and that women who receive rubella vaccine should be advised to avoid pregnancy for three months, but the patient and her physician should make the final decision.