Pregnancy Outcomes Following Rubella Vaccination: A Prospective Study in the State of Rio de Janeiro, Brazil, 2001–2002

Abstract

The absence of vaccine-related CRS cases further supports recommendations to not interrupt a pregnancy exposed to rubella vaccine virus. Monitoring pregnancy outcomes and CRI with vaccine virus can distinguish between wild-type and vaccine virus infections, especially in situations of viral circulation.

Pregnancy and infection: using disease pathogenesis to inform vaccine strategy

“…Vaccination of pregnant women is controversial, and immunization with live (i.e., replication-competent) viral or bacterial vaccines is generally contraindicated due to the theoretical risk of congenital infection and teratogenic effects from the vaccine strains. However, in a report of over 2000 pregnant women who were unknowingly immunized with live attenuated rubella vaccine, there were no cases of vaccine-associated congenital rubella infection, 91 and live virus strains of influenza or yellow fever viruses administered to pregnant women also have no link with pregnancy complications. 21 , 92 Vaccination with inactivated vaccines such as influenza and Tdap during pregnancy have low uptake, with concerns of safety among both patients and their healthcare providers being a primary barrier.…”

Congenital anomalies: Case definition and guidelines for data collection, analysis, and presentation of immunization safety data

“…The incidence of congenital rubella syndrome (CRS) following inadvertent rubella vaccination of pregnant women has been evaluated in several countries in Europe, the United States, Canada, Iran and Latin America. Among more than 3500 susceptible women inadvertently vaccinated against rubella shortly before or in the first trimester of pregnancy, no cases of CRS were reported [38], [39], [40], [41], [42], [43], [44], [45].…”

Differences in Establishment of Persistence of Vaccine and Wild Type Rubella Viruses in Fetal Endothelial Cells

“…To the best of our knowledge, the direct evidence of RA27/3 persistence in the fetus is limited to three reports, one of them documenting detection of RA27/3 virus in a product of conception by virus isolation [ 11 ] and the other two documenting detection of RA27/3 RNA in newborn specimens by RT-PCR and sequencing [ 12 , 13 ]. On the other hand, many studies failed to detect RV27/3 genomes in oropharyngeal specimens from IgM-positive infants born from vaccinated mothers [ 9 , 14 , 15 ] and no infectious virus was recovered from fetal tissues obtained after maternal immunization [ 16 ]. It is presently unclear whether the low number of reports of RA27/3 persistence in newborns is attributable to the sensitivity of currently used methods or the inability of vaccine virus to persist to term in fetal tissues.…”