Rubella Vaccination

Rubella vaccination (Rubella) is a standard vaccination (regular vaccination) for girls/women. It is given using a live vaccine and is usually given as a combination with measles–mumps–rubella vaccination (MMR vaccination). The following are the recommendations of the Standing Commission on Vaccination (STIKO) at the Robert Koch Institute:

Indications (areas of application)

  • I: Unvaccinated women or women of childbearing age with unclear vaccination statusOnce-vaccinated women of childbearing age.
  • B: Persons born after 1970 (including trainees, interns, students, and volunteers) in the following activities:
    • Medical facilities (according to § 23 (3) sentence 1 IfSG) including facilities of other human medical health professions.
    • Activities with contact to potentially infectious material.
    • Nursing facilities (according to § 71 SGB XI).
    • Community facilities (according to § 33 IfSG)
    • Facilities for the collective accommodation of asylum seekers, persons who are obliged to leave the country, refugees and ethnic German immigrants.
    • Technical, vocational and higher education institutions

Note!Often, adults born before 1970 (before the start of universal MMR vaccination) have natural immunity to measles, mumps and rubella. Legend

  • I: Indication vaccinations for risk groups with individual (not occupational) increased risk of exposure, disease or complications and for the protection of third parties.
  • B: Vaccinations due to an increased occupational risk, e.g., after risk assessment in accordance with the Occupational Health and Safety Act / Biological Substances Ordinance / Ordinance on Occupational Medical Precautions (ArbMedVV) and / or for the protection of third parties in the context of occupational activities.

Contraindications

  • Pregnant women
  • Persons with acute illnesses requiring treatment.

Implementation

  • Basic immunization: the first vaccination should be given between eleven and 14 months of age, and revaccination is then given between 15 and 23 months of age, four to six weeks apart from the previous vaccination. (A total of 2 times vaccination with an MMR vaccine (if necessary, use MMRV combination vaccine in case of simultaneous indication for varicella vaccination)).
  • Vaccination twice in unvaccinated women or women of childbearing age with unclear vaccination status.
  • One-time vaccination in:
    • Once vaccinated women of childbearing age.
  • Vaccinate twice with MMR vaccine (use MMRV combination vaccine if indicated at the same time as varicella vaccination, if necessary).
    • due toVaccinations due to increased occupational risk (B).
      • For women, 2 vaccinations are required for each of the three vaccine components (M-M-R).
      • In men, 2 times of vaccination is required for the measles and mumps vaccine components. For protection against rubella, a single vaccination is sufficient.
  • Repeat vaccination: age 2-17 years

Note: Attention should be paid to contraception (birth control) in the first 4 weeks after vaccination.

Efficacy

  • No vaccine protection occurs in five to seven percent of those vaccinated with a combination vaccine

Possible side effects / vaccination reactions

  • Local reaction with redness, swelling around the injection site – usually occur 6 to 48 hours after vaccination
  • General reactions with fever (< 39.5 C°), headache/limb pain, malaise – usually occur in the first 72 hours after vaccination
  • Arthralgia (joint pain)
  • Arthritis (inflammation of the joints)
  • If as MMR vaccination:
    • Vaccine sickness – possible up to 4 weeks after MMR vaccination; measles/mumps-like symptoms with increased body temperature (= vaccine measles) occur; mostly mild courses.
    • Parotitis (parotid gland inflammation) (occasionally to rarely).
    • Generalized lymphadenitis (lymphadenitis) (occasional to rare).

Other notes

  • The combined measles, mumps, and rubella (MMR) vaccine is effective and not associated with an increased risk of autism.
  • There is no association between autism and measles-mumps-rubella (MMR) vaccination, even in children with a genetic predisposition (hereditary disposition).
  • To date, no case of rubella embryopathy has been demonstrated in accidental vaccination shortly before or in early pregnancy. Conclusion: there is no indication for interruptio (termination of pregnancy) or prenatal diagnostics (prenatal diagnostics) in such cases.
  • In vaccinees with severe congenital immunodeficiencies, the attenuated rubella viruses in the MMR vaccine can cause chronic infection associated with severe skin damage. The congenital immunodeficiencies were ataxia teleangiectatica (Louis Bar syndrome), combined immunodeficiencies (CID), cartilage hair hypoplasia, Marden-Walker syndrome, NEMO deficiency (NF-kappa-B essential modulator), variable immunodeficiency syndrome (CVID) and X-linked agammaglobulinemia.

Vaccination status-checking vaccine titers

Vaccination Laboratory parameters Value Rating
Rubella (German measles) anti-rubella virus IgG (ELISA) > 15 IU/ml Assume immunity
HAHT HAHT 1: < 8 No evidence of sufficient vaccination protection → basic immunization required
HAHT 1: 8 Questionable vaccination protection → booster recommended
HAHT 1: 16
HAHT 1: 32 Sufficient vaccination protection