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How Effective is the Rubella Vaccine?

vaccine effectiveness

The CDC reports that 95 percent of individuals 12 months of age and older who receive one dose of the rubella vaccine (RA 27/3) contained in the MMR vaccine will develop vaccine-acquired immunity to rubella. They also report that more than 90 percent of vaccinated individuals will maintain vaccine-acquired immunity for at least 15 years.1

Waning of Rubella Vaccine Acquired Immunity

A 2009 study on the impact of a second dose of MMR vaccine in children previously vaccinated between 12 and 14 months of age found that while rubella antibodies increased significantly post-vaccination, after 12 years, the levels decreased to those lower than what were detected after a single vaccine dose. Researchers cautioned that in the U.S., where wild-type virus boosting does not occur, vaccine-acquired immunity may decrease, and urged continued monitoring of rubella disease to ensure that the disease remains eliminated.2

In 2012, the Cochrane Collaboration published a review of the available medical literature on both the effectiveness of MMR vaccine as well as its safety. In this paper, researchers noted that they could not locate any studies on the effectiveness of MMR vaccine against cases of clinical rubella.3

Evaluation of Rubella Immunity with Third Dose

A 2018 CDC study found that rubella titer levels in young adults between 18 and 31 years of age previously vaccinated with two MMR doses and who received a third MMR dose increased 4.5 times on average. This study, however, reported that within one year of receipt of the third MMR dose, 24 percent of vaccine recipients had low positive rubella antibodies.4

In January 2020, Mayo Clinic vaccine researchers published a study evaluating the effects of a third dose of MMR vaccine on women of childbearing age. This study compared the vaccine-acquired antibodies in women who had either high or low- to non-existent levels of vaccine-acquired immunity after two MMR vaccine doses and what effects a third dose of MMR would have on antibody boosting. Researchers found that while all women showed evidence of vaccine-acquired immunity after a third dose, women with low immunity prior to the third dose did not have a significant antibody boost when compared to those who had higher levels prior to vaccination. They concluded that their study “suggests the importance of yet unknown inherent biologic and immune factors for the generation and maintenance of rubella-vaccine-induced humoral immune responses.”5

Recent Rubella Effectiveness Evaluation

In April 2020, the Cochrane Collaboration updated their review of the available medical literature on the safety and effectiveness of MMR vaccine. In this updated review, they report the rubella vaccine to be 89 percent effective based on one study involving approximately 1,600 children between the ages of nine months and 15 years of age.6

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 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; Pg. 328. Updated December 2020. Accessed April 3, 2021.

2 LeBaron CW, Forghani B, Matter L et al. Persistence of rubella antibodies after 2 doses of measles-mumps-rubella vaccine. J Infect Dis September 2009; 200(6):888-99.

3 Demicheli V, Rivetti A, Debalini MG, et al. Vaccines for measles, mumps and rubella in children. Cochrane Database Syst Rev February 2012;(2):CD004407.

4 McLean HQ, Fiebelkorn AP, Ogee-Nwankwo A, et al. Rubella virus neutralizing antibody response after a third dose of measles-mumps-rubella vaccine in young adults. Vaccine. September 2018; 36(38):5732-5737.

5 Haralambieva IH, Ovsyannikova IG, Kennedy RB et al. Rubella virus-specific humoral immune responses and their interrelationships before and after a third dose of measles-mumps-rubella vaccine in women of childbearing age. Vaccine Jan. 29, 2020; 38(5):1249-1257.

6 Di Pietrantonj C, Rivetti A, Marchione et al. Vaccines for measles, mumps, rubella, and varicella in children. Cochrane Database Syst Rev. April 2020; 4:CD004407.

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