Rubella Vaccine Virus, Live (Subcutaneous)

The Rubella Virus Vaccine is a live vaccine that is used to prevent infection by the Rubella virus.

Overview

Rubella, which is also known as German measles, is a viral infection that can cause a mild facial rash, swelling behind the ears, and sometimes swelling of the joints and a low-grade fever. Some people also experience pinkeye, headaches, and general discomfort before the appearance of a rash. In pregnant women the effects are much more serious: it is known to cause miscarriage, stillbirth, or severe birth defects. At least 20% of pregnant women who contract Rubella experience these effects. It is recommended therefore that women of childbearing age be vaccinated to prevent Rubella infection.

Other people who should be vaccinated include those who work in medical facilities, adolescents, adult men, those traveling outside of the United States, and all children 12 months of age and older. The Rubella vaccine is usually administered to children alongside vaccines for measles and mumps. The three vaccines are administered together in a two-dose series. The first dose is typically administered at 12 to 15 months of age, and the second dose is generally administered at four to six years of age. The vaccine is very effective. One dose is about 97% effective at preventing infection with the Rubella virus.

Before the Rubella vaccine was available, the Rubella virus was a common infection in the United States, especially among young children. The last major epidemic in the United States happened in 1964 and 1965. There were approximately 12.5 million cases of Rubella during that epidemic. As a result of the availability of the Rubella vaccine, Rubella has been eliminated in the United States since 2004, although it is still common in other countries. This means that Americans traveling abroad can still contract the virus and spread it in the United States if they are unvaccinated.

The Rubella vaccine should not be administered to infants under 12 months of age. This is because the antibodies that they have received from their mothers may interfere with the effectiveness of the vaccine. Children who were vaccinated before they were 12 months of age should be vaccinated again to ensure effectiveness.

Immunity to Rubella is only guaranteed if you received the Rubella vaccine at 12 months of age or older, or if you have medical documentation of a past Rubella infection or blood work showing immunity. Past infection without a medical record does not guarantee immunity because the symptoms of another infection may be mistaken for the symptoms of Rubella. Those who were born before 1957 do not need to receive the Rubella vaccine. Rubella was so prevalent at that time that nearly everyone born before 1957 is presumed to have been infected by Rubella, and to therefore be immune.

People who were vaccinated prior to 1968 may need to be revaccinated. Those who received an inactivated, or killed vaccine, or those who received a vaccine of an unknown type, should be revaccinated with at least one dose of live vaccine. The killed or inactivated vaccine was not effective and does not guarantee immunity to those who received it.

The Rubella Virus vaccine works by prompting the body to create its own antibodies to fight off the infection.

The vaccine is available as:

  • Powder for solution
  • Injectable

The vaccine should only be administered by a doctor or a medical professional. Vaccination is not recommended for infants under 12 months of age.

Conditions Treated

  • Rubella Virus (preventative)

Type of Medicine

  • Live vaccine, subcutaneous route

Side Effects

Most people have no side effects from receiving the Rubella vaccine. For those who experience side effects, most are mild and last less than a week.

The following side effects are more likely to occur in adults, especially women. Your doctor may be able to help you prevent or minimize some of the following side effects. Side effects may not appear immediately and can show up four weeks after immunization. Aches and pains can show up 10 weeks after immunization. These side effects usually last less than one week.

Common side effects include:

  • Burning at injection site
  • Skin rash
  • Swelling of neck glands
  • Less common side effects:
  • Joint pain or achiness
  • Headache, sore throat, fever, or runny nose
  • Nausea
  • General discomfort
  • Itching, tenderness, swelling, redness, or a hard lump at injection site

Some side effects are less common and may indicate a possible allergic reaction or a serious medical condition.

If you experience any of the following side effects, contact your doctor immediately:

  • Difficulty breathing or swallowing
  • Hives
  • Itching, especially of the hands or feet
  • Skin reddening, especially around the ears
  • Swelling of the eyes, face, or inside of the nose
  • Unusual fatigue or weakness that is sudden and severe

If you experience any of the following side effects, contact your doctor as soon as possible:

  • Eye pain or tenderness
  • Bruising or purple spots on skin
  • Confusion
  • Convulsions (seizures)
  • Severe or continuing headache
  • Pain, numbness, or tingling of hands, feet, arms, or legs
  • Stiff neck
  • Unusual irritability
  • Vomiting

Dosage

The dose of this vaccine will be different depending on the individual patient. Your doctor or a medical professional should determine your dose. It is important to follow your doctor’s orders or the directions on the label. If your dose is different from the dose on the label, do not change it unless your doctor tells you to do so.

For most people, the following dose will be appropriate for the prevention of Rubella:

Adults and children 12 months of age and older - One dose injected under the skin

Children up to 12 months of age - Vaccination is not recommended

Interactions

Your doctor should be made aware of any medications that you are taking before you are given the Rubella vaccine. Certain drugs can interact with the vaccine in a way that your doctor can manage by changing the dose or making other alterations. In other cases, your doctor may decide that you may not be able to combine the vaccine with another medication at all. It is very important to disclose to your doctor any medications you are taking at the time that you receive your Rubella vaccination.

The following medications are considered to have significant effects when interacting with the Rubella vaccine. This list may not be exhaustive, but it covers those with the most significant interactions.

It is not recommended to combine the following drugs with the Rubella vaccine at all. Your doctor may choose to change the medications that you take or tell you not to receive the Rubella vaccine.

  • Alemtuzumab
  • Bendamustine
  • Bortezomib
  • Bosutinib
  • Cabazitaxel
  • Capecitabine
  • Carboplatin
  • Carfilzomib
  • Carmustine
  • Chlorambucil
  • Cisplatin
  • Cladribine
  • Clofarabine
  • Cyclophosphamide
  • Cytarabine
  • Cytarabine Liposome
  • Dacarbazine
  • Dasatinib
  • Daunorubicin
  • Daunorubicin Citrate Liposome
  • Deflazacort
  • Docetaxel
  • Doxorubicin
  • Epirubicin
  • Etoposide
  • Fludarabine
  • Fluorouracil
  • Gemcitabine
  • Gemtuzumab Ozogamicin
  • Hydroxyurea
  • Idarubicin
  • Ifosfamide
  • Imatinib
  • Interferon Alfa
  • Irinotecan
  • Irinotecan Liposome
  • Lomustine
  • Mechlorethamine
  • Melphalan
  • Mercaptopurine
  • Methotrexate
  • Mitomycin
  • Mitoxantrone
  • Nelarabine
  • Nilotinib
  • Ofatumumab
  • Oxaliplatin
  • Paclitaxel
  • Paclitaxel Protein-Bound
  • Pemetrexed
  • Pentostatin
  • Ponatinib
  • Procarbazine
  • Rituximab
  • Temozolomide
  • Teniposide
  • Topotecan
  • Tositumomab
  • Vinblastine
  • Vinorelbine

Receiving the Rubella vaccine with any of the following medications is usually not recommended, but it may occasionally be required. Your doctor may change your dose of the vaccine or when you take your medication.

  • Adalimumab
  • Azathioprine
  • Certolizumab Pegol
  • Etanercept
  • Everolimus
  • Fingolimod
  • Golimumab
  • Immune Globulin
  • Infliximab
  • Leflunomide
  • Mycophenolic Acid
  • Rilonacept
  • Secukinumab
  • Sirolimus
  • Teriflunomide
  • Trabectedin
  • Ustekinumab

Receiving the Rubella vaccine while taking the following drug may increase your risk of side effects, but your doctor may determine that this is still the best option for you.

  • Abatacept

Warnings

There are some medications that should not be used around the time of eating or drinking. This is because there is a possibility that interactions can occur. The use of alcohol or tobacco while taking certain medications can also cause interactions to occur. Talk to your doctor about your use of alcohol and tobacco, and about any medications that you take, to prevent these interactions from occurring.

The presence of other medical problems can also affect the use of this vaccine. Before being vaccinated, tell your doctor if you have any existing medical conditions, especially the following:

Immune deficiency condition, or a family history of immune deficiency condition. This condition may increase the chance and the severity of side effects and/or may reduce the effectiveness of the vaccine.

Severe illness with fever. The symptoms of the condition may be confused with the side effects of the vaccine.

There are other groups of people who should not receive the vaccine. These include:

  • Those who have a life-threatening allergy to gelatin or neomycin
  • Those who had a life-threatening allergic reaction to their first dose of the vaccine
  • Those who may be pregnant or are planning to become pregnant within 4 weeks of receiving the vaccine
  • Those with weakened immune systems due to HIV/AIDS, cancer drugs, or corticosteroids

Do not become pregnant within 3 months of receiving the vaccine without discussing it with your doctor first. There is a chance that the vaccine could cause birth defects if you become pregnant within this time period of receiving the vaccine. It is safe for pregnant women to be around those who have recently been vaccinated.

Tell your doctor that you have received this vaccine if:

  • You are to receive a tuberculin skin test within 4-6 weeks after receiving the vaccine. The vaccine may alter the results of this test.
  • You are to receive blood transfusions or other blood tests within 2 weeks after receiving the vaccine.
  • You are to receive gamma globulin or other immune globulins within 2 weeks after receiving the vaccine.

Storage

The Rubella vaccine should be stored at temperatures between -58°F and +46°F (-50°C to +8°C). The vaccine should not be stored with dry ice, which may lead to a temperature of less than -58°F. Before reconstitution, store the lyophilized vaccine at 36°F to 46°F (2°C to 8°C). The vaccine should be protected from light at all times, as light can cause the viruses to become inactive. The diluent may be stored at the same temperature as the lyophilized vaccine or separately at room temperature. The diluent MUST NOT be frozen.

Summary

While there are risks from receiving the Rubella vaccine, as there are with any vaccine, the benefits far outweigh the risks. The Rubella vaccine can prevent infection with the Rubella virus. Although the virus causes relatively mild symptoms in children and adult men, Rubella can cause serious birth defects, miscarriage, or stillbirth if contracted by a pregnant woman. For this reason, every woman of childbearing age should be vaccinated against Rubella, as should children over 12 months of age, adult men, and people who work in medical facilities.

The Rubella vaccine is commonly administered to children in a 2-dose series alongside the vaccines for mumps and measles. Only by having received the Rubella vaccine or by having medical documentation of a past Rubella infection can a person be considered to be immune to the virus.

Many medications can have dangerous interactions with the Rubella vaccine. Discuss with your doctor any medications that you take or any medical conditions that could cause complications of the vaccine. Your doctor will decide if the vaccine is safe for you to take with your medications or medical conditions. The Rubella vaccine is not safe for pregnant women and can be ineffective when administered to children under 12 months of age. People in these groups should not receive the Rubella vaccine. However, for most people, the Rubella vaccine is safe and leads to minimal side effects.

 

Resources
Last Reviewed:
January 29, 2018
Last Updated:
January 27, 2018
Content Source: