You are here

Does rubella vaccination prevent congenital rubella syndrome?

Daily News Navigator

Vaccination is known to result in a subclinical or mild case of the disease for which one is being vaccinated against. 

Rubella (German measles) is a disease for which there is a widely used vaccine.  (It is generally administered via the MMR vaccine.)  It is, in itself, a mild, often even subclinical disease.  The reason it is recommended/mandated is to protect the developing fetus, which if it is exposed to the virus during a critical period while still in the womb, can develop a serious condition called congenital rubella syndrome

There is evidence that the rubella vaccinated, including pregnant women, are getting subclinical cases of rubella, just as is the rest of the population.  What does vaccination accomplish if all it does is result in a subclinical case of an already mild or subclinical disease? 

Moreover, what does vaccination accomplish if previously vaccinated pregnant women not only can get  subclinical cases of rubella, but that such a cases can result in congenital rubella syndrome (CRS)?

Unfortunately rubella vaccine immunity also appears to wane over time.  On the other hand, natural immunity to rubella is thought to generally be lifelong.

Would it not be better to expose children, particularly non-immune teenage girls, to rubella in order to increase the likelihood that one would be immune during pregnancy, rather than to risk the possibility of getting rubella while pregnant?  As Dr. Hugh Paul stated in "The Control of Diseases", which was written in 1964, before formulation of the rubella vaccine, "The disease (rubella) cannot be prevented, and in view of its very mild character, and the possibility that it may have catastrophic effects if contracted by an expectant mother, it is questionable if it should be prevented in childhood and adolescence even if this were possible.  It has been suggested that female children should be deliberately exposed to infection in order to achieve a life-long immunity from the disease and possibly from malformation in the offspring in later life.  This idea is not an unreasonable one... Rubella does not kill, and even complications are uncommon." 

And if rubella during pregnancy is often subclinical among the vaccinated, how diligent are we being in evaluating newborns for congenital rubella syndrome since serological testing is necessary to confirm CRS and often even rubella itself? 

There are a number of symptoms associated with the condition.  Two of the possible symptoms are "developmental delay" and hearing loss, both of which might not be noticed immediately.  Are we assuming something isn't congenital rubella syndrome simply because the mother was vaccinated?  Are we testing every infant or child who shows "developmental delay" or hearing loss for CRS?

The textbook "Vaccines" lists a group of "prominent clinical findings in congenital rubella syndrome". Among them are autism and diabetes.  Are we testing every infant and child with autism or diabetes for CRS?

Some of these conditions, including autism and diabetes, are even thought to be on the rise.  The question was just raised whether we might be assuming conditions cannot be related to pregnancy-acquired rubella merely because of  widespread rubella vaccination.  Are we even doing this with conditions thought to be increasing? 

Could these increases possibly even have something to do with rubella vaccine causing more women of child-bearing age to be vulnerable to the disease, now that they no longer achieve natural immunity during childhood?

Are we conducting laboratory testing of every infant or child who shows one or more of the numerous symptoms associated with CRS?  If not, isn't it possible that we have been overestimating rubella vaccine's success in eliminating congenital rubella syndrome?  Of even more concern, might rubella vaccine be at least partly responsible for the rising incidence of some CRS-associated conditions?

Sandy Gottstein 

Date: 7-19-2002