Rubella and pregnancy: failed prevention policies

Objective: Postpartum rubella immunization can prevent 33-50% of all cases of congenital rubella. Our purpose was to assess missed opportunities for postpartum rubella vaccination.Methods: A retrospective prenatal record review of 304 women attending a high risk obstetrics clinic was done. The rubella status on the first prenatal visit was recorded. Rubella status was determined by immunoassay (ELISA) and reported as immune, uncertain, or nonimmune. For rubella nonimmune women their ethnicity, age, parity, and place of delivery were recorded.Results: Fifteen (4.9%) of the 304 women were nonimmune to rubella. Of the 15 women, 6 were white, 4 were Afro-American, and 5 were Hispanic. The mean age was 30.1 +/- 6.2 y (range 20-42 y). Thirteen had given birth at least once (range 1-4), while two were nulliparous. Eleven of the 13 women gave birth in the USA, while two gave birth in South America. These eleven women gave birth 20 times without receiving rubella counseling or vaccination.Conclusion: Recommendation for postpartum rubella vaccination of nonimmune women should be adhered to in order to decrease the risk of congenital rubella syndrome.