Children at 13 months and 4 years as part of MMR vaccine.
Teenage female patients as part of school immunisation
schedule until catch-up programme complete.
Female patients of childbearing age who are not rubella
immune and may become pregnant.
Frequency
Once (immunity may not be lifelong).
Contraindications
Rubella immunisation should be avoided in early
pregnancy, and women of child-bearing age should be advised
not to become pregnant within 1 month of immunisation.
However, despite active surveillance in the UK, the USA,
and Germany, no case of congenital rubella syndrome has
been reported following inadvertent immunisation shortly
before or during pregnancy. There is thus no evidence
that the vaccine is teratogenic, and routine termination
of pregnancy following inadvertent immunisation should
not be recommended; potential parents should be given
this information before making a decision about
termination.
Live vaccines should be postponed until at least 3 months
after stopping corticosteroids or immunoglobulin
injection and 6 months after stopping chemotherapy. Avoid
in patients with reticulo-endothelial system diseases or
where normal immunological systems may be impaired.
Any febrile illness.
Anaphylaxis to polymyxin or neomycin.
Practice strategy
Children are immunised as part of the child health
programme.
Female patients aged 17-18 are contacted by letter if the
practice has no record of their rubella status (annual computer
search).
A reminder is added to each patient record of female
patients aged 16-25 without a record of rubella status
(unless sterilised, hysterectomised or refused) (annual computer
search) to allow opportunisticdiscussion about
rubella.
Rubella status is covered in the contraceptive sophie wcscont.gdl.
Rubella status is covered in the preconceptual care
package.
Rubella status is determined at the start of every
pregnancy and immunisation is given after delivery if
required.
