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.
Rubella vaccine is recommended for adolescents and adults unless proof of immunity is available.
A clinical diagnosis of rubella is not reliable. Immunity can be proved by documentation of immunization at or after one year of age or by a positive serologic test. The hemagglutination inhibition assay is most widely used, but other equally reliable tests are also available. All susceptible individuals are candidates for immunization, particularly women of childbearing age and those in high-risk groups, such as college students, military personnel, hospital workers, and overseas travelers. Rubella vaccine is contraindicated for pregnant women and immunocompromised patients.