18 Rubella

18.4 Vaccines

18.4.1 Available vaccines

Rubella vaccine is one of the components of the live attenuated measles-mumps-rubella (MMR) and measles-mumps-rubella-varicella (MMRV) vaccines, considered in sections 11.4.1 and 21.4.1. Single-antigen rubella vaccine is no longer available in New Zealand.

Funded vaccine

MMR vaccine funded as part of the Schedule is MMR II (MSD), which contains further attenuated Enders’ Edmonston (Moraten) strain measles, RA 27/3 rubella, and Jeryl Lynn mumps. (See section 11.4.1 for more information.)

18.4.2 Efficacy and effectivenessTop

The rubella vaccine has been shown to be 90–97 percent effective in an outbreak after a single dose, and this is likely to be higher with a two-dose schedule. One dose of rubella vaccine at 12 months or older induces an antibody response in at least 95 percent of recipients. Studies have found no evidence of waning of protection over decades of follow-up.1, 3 In 90 percent of recipients, antibodies persisted for at least 16 years; other studies have reported persistence up to 21 years.1 A few recipients fail to produce antibodies following immunisation, and a small number of individuals lose antibodies, whether derived from natural infection or the vaccine. See also section 11.4.2 for further evidence on the duration of immunity.

18.4.3 Transport, storage and handlingTop

Transport according to the National Guidelines for Vaccine Storage and Distribution.4 Store in the dark at +2oC to +8oC. Do not freeze.

MMR vaccine must be reconstituted only with the diluents supplied by the manufacturer. Use MMR vaccine as soon as possible after reconstitution. If storage is necessary, reconstituted MMR vaccine can be stored in the dark at +2oC to +8oC for up to eight hours.

18.4.4 Dosage and administrationTop

The dose of MMR is all of the reconstituted vaccine (approximately 0.5 mL) administered by subcutaneous injection in the deltoid area to all age groups (see section 2.3).

Co-administration with other vaccines

MMR vaccine can be given concurrently with other vaccines, as long as separate syringes are used and the injections are given at different sites.

If not given concurrently, live vaccines should be given at least four weeks apart.