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What is Rubella Vaccine?

shingles

Rubella vaccine is a weakened (attenuated) form of the live rubella virus. Currently, there are two available vaccines for use in the U.S.: Merck's MMRII, which contains measles, mumps and rubella vaccine, live;1 and Merck's ProQuad (MMRV), which contains measles, mumps, rubella and varicella vaccine, live.2

Merck’s MMRII is licensed and recommended for individuals aged 12 months or older. It is a live attenuated virus vaccine propagated in chick embryo cells and cultured with Jeryl Lynn live attenuated mumps virus, and Meruvax II, a live attenuated rubella virus vaccine propagated in WI-38 human diploid lung fibroblasts.3 The WI-38 human diploid cell line was derived from the lung tissue of an aborted three-month human female embryo.4 The growth medium used was salt solution and ten percent calf (bovine) serum.5

Merck's ProQuad is licensed and recommended for individuals aged 12 months to 12 years of age. ProQuad (Measles, Mumps, Rubella and Varicella Virus Vaccine, Live) is a combined, attenuated, live virus vaccine containing measles, mumps, rubella, and varicella viruses. ProQuad is a sterile lyophilized preparation of the components of M-M-R II (Measles, Mumps, and Rubella Virus Vaccine Live): Measles Virus Vaccine Live, and Varicella Virus Vaccine Live (Oka/Merck), the Oka/Merck strain of varicella-zoster virus propagated in MRC-5 cells. MRC-5 cells are derived from a cell line that was developed in 1966 from lung tissue taken from a 14-week aborted fetus and contains viral antigens.6

Rubella Vaccine Ingredients

The growth medium for measles and mumps for both MMRII7 and ProQuad8 is a buffered salt solution containing vitamins and amino acids and supplemented with fetal bovine serum containing sucrose, phosphate, glutamate, and recombinant human albumin, and neomycin. The growth medium for rubella is a buffered salt solution containing vitamins and amino acids and supplemented with fetal bovine serum containing recombinant human albumin and neomycin. Sorbitol and hydrolyzed gelatin stabilizer are added to the individual virus harvests. In the ProQuad vaccine,9 the Oka/Merck strain of the live attenuated varicella virus, initially obtained from a child with wild-type varicella, introduced into human embryonic lung cell cultures, adapted to and propagated in embryonic guinea pig cell cultures and finally propagated in aborted human diploid cell cultures (WI-38) is added to the MMRII component.

According to Merck, both MMRII and ProQuad vaccines are screened for adventitious agents. Each dose of MMRII contains sorbitol, sodium phosphate, sucrose, sodium chloride, hydrolyzed gelatin, recombinant human albumin, fetal bovine serum, other buffer and media ingredients and neomycin.10 Each dose of ProQuad contains sucrose, hydrolyzed gelatin, sorbitol, MSG, sodium phosphate, human albumin, sodium bicarbonate, potassium phosphate and chloride, neomycin, bovine calf serum, chick embryo cell culture, WI-38 human diploid lung fibroblasts and MRC-5 cells.11 12

The MMRII vaccine package insert states that the MMRII vaccine should be given one month before or one month after any other live viral vaccines.13 The ProQuad vaccine package insert states that one month should lapse between administration of ProQuad and another measles containing vaccine such as MMRII and at least three months should lapse between ProQuad and any varicella containing vaccine.14

Rubella Vaccine Administration Recommendations

Currently, the CDC recommends that children receive two doses of a rubella containing vaccine, with the first dose administered between the ages of 12-15 months, and the second dose administered between the ages of 4-6 years.15 The CDC also recommends that individuals born after 1957 and have no laboratory evidence of immunity or documentation of vaccination should receive at least one dose of MMR vaccine. Two doses of MMR vaccine are recommended for healthcare personnel, students entering college and other post-high school educational institutions, and anyone traveling internationally.16

The CDC also recommends MMR vaccination for infants between 6 and 12 months of age who may be traveling internationally;17 however, both ProQuad18 and MMRII19 are only FDA approved for use in children older than 12 months of age. The MMRII vaccine package insert states that the effectiveness and safety of administration of MMRII has not been established in children between the ages of 6 and 12 months of age and if administered to this population, antibodies may not develop. According to the CDC, an infant vaccinated prior to 12 months of age would still require two additional doses of MMR vaccine.20

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.

« Return to Vaccines & Diseases Table of Contents

References

1 Merck, Sharp & Dohme Corp. Measles, Mumps and Rubella Virus Vaccine, Live Package Insert. U.S. Food and Drug Administration Dec. 14, 2020.

2 Merck, Sharp & Dohme Corp. Package Insert - Refrigerator-Stable Formulation - ProQuad. U.S. Food and Drug Administration Sept. 17, 2020.

3 Merck, Sharp & Dohme Corp. Measles, Mumps and Rubella Virus Vaccine, Live Package Insert. U.S. Food and Drug Administration Dec. 14, 2020.

4 Wadman M. Medical research: Cell Division. Nature Jul. 2013; 498: 422–426.

5 Merck, Sharp & Dohme Corp. Measles, Mumps and Rubella Virus Vaccine, Live Package Insert. U.S. Food and Drug Administration Dec. 14, 2020.

6 Merck, Sharp & Dohme Corp. Measles, Mumps and Rubella Virus Vaccine, Live Package Insert. U.S. Food and Drug Administration Dec. 14, 2020.

7 Merck, Sharp & Dohme Corp. Measles, Mumps and Rubella Virus Vaccine, Live Package Insert. U.S. Food and Drug Administration Dec. 14, 2020.

8 Merck, Sharp & Dohme Corp. Package Insert - Refrigerator-Stable Formulation - ProQuad. U.S. Food and Drug Administration Sept. 17, 2020.

9 Merck, Sharp & Dohme Corp. Package Insert - Refrigerator-Stable Formulation - ProQuad. U.S. Food and Drug Administration Sept. 17, 2020.

10 Merck, Sharp & Dohme Corp. Measles, Mumps and Rubella Virus Vaccine, Live Package Insert. U.S. Food and Drug Administration Dec. 14, 2020.

11 Merck, Sharp & Dohme Corp. Package Insert - Refrigerator-Stable Formulation - ProQuad. U.S. Food and Drug Administration Sept. 17, 2020.

12 U.S. Centers for Disease Control and Prevention. Vaccine Excipient & Media Summary. Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book). February 2020.

13 Merck, Sharp & Dohme Corp. Measles, Mumps and Rubella Virus Vaccine, Live Package Insert. U.S. Food and Drug Administration Dec. 14, 2020.

14 Merck, Sharp & Dohme Corp. Package Insert - Refrigerator-Stable Formulation - ProQuad. U.S. Food and Drug Administration Sept. 17, 2020.

15 McLean HQ, Fiebelkorn AP, Temte JL. et al. Prevention of Measles, Rubella, Congenital Rubella Syndrome, and Mumps, 2013: Summary Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Jun. 2013; 62(RR04):1-34.

16 McLean HQ, Fiebelkorn AP, Temte JL. et al. Prevention of Measles, Rubella, Congenital Rubella Syndrome, and Mumps, 2013: Summary Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Jun. 2013; 62(RR04):1-34.

17 McLean HQ, Fiebelkorn AP, Temte JL. et al. Prevention of Measles, Rubella, Congenital Rubella Syndrome, and Mumps, 2013: Summary Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Jun. 2013; 62(RR04):1-34.

18 Merck, Sharp & Dohme Corp. Package Insert - Refrigerator-Stable Formulation - ProQuad. U.S. Food and Drug Administration Sept. 17, 2020.

19 Merck, Sharp & Dohme Corp. Package Insert - Refrigerator-Stable Formulation - ProQuad. U.S. Food and Drug Administration Sept. 17, 2020.

20 McLean HQ, Fiebelkorn AP, Temte JL. et al. Prevention of Measles, Rubella, Congenital Rubella Syndrome, and Mumps, 2013: Summary Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Jun. 2013; 62(RR04):1-34.


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