Who is at highest risk for complications from Rubella vaccine?

In the U.S., the rubella vaccine is only available in combination with measles and mumps vaccine (MMRII) or measles, mumps, and varicella vaccine (MMR-V). 

According to the MMRII package insert,  persons most at risk for complications from MMRII vaccine include individuals with both primary and acquired immunodeficiency such as AIDS, dysgammaglobulinemic and hypogammaglobulinemic states, and cellular immune deficiencies. Pneumonitis, measles inclusion body encephalitis, and death have also occurred because of being inadvertently vaccinated with a measles containing vaccine.

Persons with thrombocytopenia or history of the condition may also be at greater risk for exacerbation or redevelopment of thrombocytopenia with subsequent doses of MMRII vaccine.

Individuals with a personal history of cerebral injury, personal or family history of seizures, or any other health condition where stress related to fever should be avoided, may also be at greater risk for complications.

As both the live measles and live mumps vaccines are manufactured using chick embryo cell culture, individuals with a history of an immediate reaction, as well as those with anaphylactic and anaphylactoid reactions to eggs may be at greater risk of a reaction from the MMRII vaccine. MMRII contains neomycin and persons who have previously experienced an anaphylactic reaction to either systematic or topical neomycin should not be vaccinated with MMRII due to the risk of reaction and subsequent complications resulting from the reaction.

Merck’s MMR-V (ProQuad) vaccine package insert  states that children between the ages of 12 and 23 months with no history of vaccination or wild-type infection with measles, mumps, rubella, and varicella have a higher risk of fever and febrile seizure between 5- and 12-days following vaccination with MMR-V when compared to children who were vaccinated with separate doses of MMRII and varicella vaccine. Children with a personal or family history of convulsion or a personal history of cerebral illness or medical condition where stress from fever should be avoided may also be at a greater risk of complications from MMR-V.

Individuals most at risk for complications from MMR-V vaccine include persons with both primary and acquired immunodeficiency such as AIDS, dysgammaglobulinemic and hypogammaglobulinemic states, and cellular immune deficiencies. Pneumonitis, measles inclusion body encephalitis, and death have also occurred from being inadvertently vaccinated with a measles containing vaccine. Additionally, reports of disseminated varicella vaccine virus infection occurring in children with underlying immunodeficiency disorders inadvertently with a varicella-containing vaccine have also been documented.

According to the package insert for GlaxoSmithKline’s PRIORIX, individuals most at risk for complications from vaccination include persons with a past history of allergic or anaphylaxis to any ingredient of the vaccine, or to a previous dose of the vaccine. Additionally, pregnant women and individuals who are immunosuppressed who are vaccinated with PRIORIX are at a high risk of suffering complications. 

IMPORTANT NOTE: NVIC encourages you to become fully informed about Rubella and the Rubella vaccine by reading all sections in the Table of Contents, which contain many links and resources such as the manufacturer product information inserts, and to speak with one or more trusted health care professionals before making a vaccination decision for yourself or your child. This information is for educational purposes only and is not intended as medical advice.

 

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