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Prepregnancy waiting time after Rubella vaccine shortened

ATLANTA (Reuters Health) – The recommended waiting period before becoming pregnant after a rubella vaccination has been decreased from 3 months to 28 days, according to researchers at the US Centers for Disease Control and Prevention (CDC).

The CDC announced the change made by the CDC's Advisory Committee on Immunization Practices (ACIP) in the December 14th issue of the agency's Morbidity and Mortality Weekly Report.

According to Dr. Sue Reef with the CDC's National Immunization Program, the recommendation, now 28 days, has been at 3 months since 1977.

"I think this is a very important change, because many people may be hesitant to get the vaccination at all if they have to wait such a long period of time before getting pregnant," she told Reuters Health.

ACIP made the change on October 18 after various data indicated that that "no cases of congenital rubella syndrome had been identified among infants born to women who were vaccinated inadvertently against rubella within 3 months or early in pregnancy."

But a theoretical risk cannot be ruled out, they note. When the CDC limited the analysis to the 293 infants born to susceptible mothers vaccinated 1 to 2 weeks before and 4 to 6 weeks after conception, the maximum theoretical risk was 1.3%.

Compared with a greater than 20% risk of congenital rubella syndrome associated with maternal infection during the first 20 weeks of pregnancy, "this risk is substantially less," they note.

According to the CDC, clinicians should counsel women to avoid becoming pregnant for 28 days after vaccination the MMR or other rubella-containing vaccines. The MMR vaccine and its component vaccines should not be administered to women known to be pregnant, they point out.

According to the CDC, most rubella cases in the US occur among young Hispanic adults born outside the country, and most infants with congenital rubella syndrome are born to foreign-born mothers.

"Ensuring immunity in women of childbearing age, especially those at highest risk for exposure, will help to prevent congenital rubella syndrome," they note.

MMWR 2001;50:1117.

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