Rubella Susceptibility Predicts Measles Susceptibility: Implications for Postpartum Immunization

The goal of rubella immunization is the elimination of the congenital rubella syndrome (CRS). Protection from CRS is accomplished for the large majority of women in developed countries by routine childhood immunization(s) against rubella. A small number of women in their childbearing years, however, remain susceptible to rubella virus because of missed vaccinations (either intentional or unintentional) or vaccine failure. Prenatal screening of pregnant women for rubella antibodies is widely recommended to identify these susceptible women so that they can be offered vaccination postpartum. This strategy aims to eliminate the risk of CRS in the subsequent pregnancies. Whether to offer rubella vaccination alone or in combination with measles vaccine (MR) or measles and mumps vaccines (MMR) has only recently been considered by some national advisory bodies. For example, only the most recent recommendation of the Advisory Committee on Immunization Practices (ACIP) states that MMR vaccine should be offered to all rubella-seronegative women of childbearing age [1], whereas recommendation of the Canadian National Advisory Committee on Immunization calls simply for “rubella vaccination” in these women [2].