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Who is at Highest Risk for Complications from Rubella?


For most people, rubella is a mild, self-limiting illness; however, a woman who develops rubella during the first three months of pregnancy has a greater chance of miscarriage and of giving birth to a baby with congenital rubella syndrome (CRS) and birth defects.1 

Infants with CRS can have multiple health issues affecting nearly all organs of the body, including deafness, vision impairments, cardiac defects, microcephaly, neurological abnormalities, developmental delays, and more.2 Up to 85 percent of infants exposed to rubella in the first eight weeks of fetal development are at risk for CRS. By 12 weeks, the risk decreases to 50 percent and by 20 weeks, the risk is essentially zero.3

In 2018, there were four reported cases of rubella in the U.S. and between 2009 and 2017, there were an average of five rubella cases per year. There were no reported cases of CRS in the U.S. in 2018.4 5

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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1 Lambert N, Strebel P, Orenstein W, et al. Rubella. Lancet Jan. 2015; 385(9984): 2297–2307.

2 Communication and Education Branch, National Center for Immunization and Respiratory Diseases (NCIRD) and the Centers for Disease Control (CDC). Rubella. In: Epidemiology and Prevention of Vaccine-Preventable Diseases. 13th ed. Centers for Disease Control (CDC) 2015; p. 326. Updated December 2020. Accessed April 3, 2021.

3 National Organization for Rare Disorders (NORD) Rubella, Congenital In: Rare Disease Database. 2004. Accessed April 3, 2021.

4 U.S. Centers for Disease Control and Prevention. TABLE 2l. Annual reported cases of notifiable diseases, by region and reporting area - - United States and U.S. Territories, 2018. In: National Notifiable Diseases Surveillance System. 2019.

5 World Health Organization (WHO). Incidence time series for United States of America (USA). In: WHO vaccine-preventable diseases: monitoring system. Oct. 12, 2020.

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