http://bmj.com/cgi/content/full/322/7300/1489
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Letters
Pregnancy is contraindication for rubella vaccination still
Some
of the statements in Josefson's news report of the Canadian study on
inadvertent rubella vaccination in pregnancy might mislead a British
audience.1
Since 1990 the Department of Health for the United Kingdom has
advised that conception should be avoided for one month, rather than
three months, after rubella vaccination. Furthermore, termination of
pregnancy is no longer recommended even if vaccination does occur
shortly before conception or during pregnancy.2 This was
in the light of data collected in the United States, Germany,
Sweden, and the United Kingdom, in which the outcome of pregnancies
affected by inadvertent rubella vaccination was monitored.3
In England and Wales fewer than 40 terminations associated with rubella
vaccination have been reported over the past 10 years, compared
with over 400 in the previous 10 years.4 Over 100 live
born infants have been reported to the rubella vaccination in
pregnancy study, which is part of the national congenital rubella surveillance
programme; 60% of their mothers were known to be susceptible to
rubella at vaccination. No infant has been reported with congenital
rubella syndrome. Nevertheless, among 25 tested infants whose
susceptible mothers were vaccinated more than one week after
conception, four had rubella immunoglobulin M at birth. Although it
is reassuring that no child has been born with symptoms attributable
to congenital rubella infection, it is quite another matterand
not appropriateto
suggest that rubella vaccine is safe in early pregnancy.
Pat Tookey
National Congenital Rubella Surveillance Programme, Institute of Child Health,
London WC1N 1EH p.tookey@ich.ucl.ac.uk
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1. |
Josefson D. Rubella vaccine may be safe in early
pregnancy. BMJ 2000; 322: 695 |
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2. |
Department of Health. Immunisation against infectious
disease. London: Stationery Office, 1996. |
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3. |
Tookey PA, Jones G, Miller BHR, Peckham CS. Rubella
vaccination in pregnancy. Commun Dis Rep CDR Wkly 1991; 1: R86-R88 |
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4. |
Office for National Statistics. Abortion statistics.
London: Stationery Office, 2000. |
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