Rubella infection in pregnancy.

Resolved question:
Dear Doc,

I have got the following test done. Kindly interpret the report to me as I intend to get pregnant.

1. ANTIBODIES TO MEASLES (RUBEOLA) IgG Result 386.46 Unit: IU/l
2. MUMPS IgG ( ELISA) Result: 79.23 Unit RU/ml
3. RUBELLA IgG (ELISA) Result 0.0 Unit: IU/ml

Kindly let me know if I need to get vaccinated for Rubella.

Regards.
OFS

Submitted: 4 Days
Category: Family Physician-GP

Expert:  Dr. Jaydeep Tripathy replied 4 Days.

Hello and thankyou for approaching DoctorSpring with your query.
I have gone through your tests results. It shows that you have antibodies against measles and mumps which is a good thing. But you have no antibodies against Rubella, hence you have no protection against Rubella.
If one gets a Rubella infection during pregnancy, the baby can get congenital defects as a result of the infection.
Hence ideally you should get an MMR vaccine, which is a (measles,mumps,rubella) before you get pregnant to protect you from getting a Rubella infection.

You need to take one dose of MMR vaccine and repeat a 2nd dose after 28 days.

You CANNOT get pregnant for atleast a month after the second dose of the vaccine.
If you are already trying to get pregnant, then you should NOT take the vaccine. If you are already pregnant also, you should NOT take the vaccine.

Hence I would advise you to do the following,
1)Get a pregnancy test. You can get your serum hCG levels tested.
2) If you test negative and you have just got your period, you can get vaccinated with MMR.
3) Repeat the vaccine after 28 days.
4) Make sure you do not get pregnant for atleast a month after your second dose, ideally longer is better.
5) If you have an allergy to egg, inform your doctor as you can be allergic to the vaccine. In such a case you will have to be monitored during the vaccine to prevent a reaction to the vaccine.

As I have said earlier DO NOT take the vaccine if you are already trying to get pregnant, or there are chances that you will be pregnant.

I hope this has helped.
Feel free to follow up.
Thankyou.


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Patient replied :

You have said that I have immunity to Measles and Mumps, and not Rubella (German Measles). Shouldn't I just take the Rubella vaccine as apposed to MMR.


Expert:  Dr. Jaydeep Tripathy replied 3 Days.

Hello,
Rubella vaccine comes as a part of the MMR vaccine and is the recommended vaccine. If a person has no antibodies to Rubella, they should take the MMR vaccine. Even though you have antibodies to measles and mumps, you can take the MMR vaccine.
I hope this has helped.
Thankyou

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Patient replied :

Thanks for the clarification. Kindly let me know the injection dosage and follow up vaccine shot. The doctors that I previously consulted have only said Rubella vaccine and have not mentioned any second dose. Im confused.


Expert:  Dr. Jaydeep Tripathy replied 2 Days.


Hello,
If you have taken MMR during childhood then you need to take only one dose. It is most likely that you have taken MMR during childhod.
If you have not taken previous vaccination for MMR, ideally you should take 2 doses 28 days apart.
A single dose of MMR gives 95% antibody response which gives about 90% protection. If you are not at a high risk of getting Rubella, one dose is sufficient. High risk individuals of rubella are those who work in healthcare settings, travel, work or study in schools and universities. You can discuss this with your doctor.
The dose for the vaccine is 0.5 mL given subcutaneously.

I hope this has helped.
Thankyou

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