18 Rubella

Key information

Mode of transmission By direct or droplet contact with infected nasopharyngeal secretions.

Infants with congenital rubella syndrome (CRS) shed rubella virus in their pharyngeal secretions and urine.
Incubation period 14–23 days, usually 16–18 days.
Period of communicability 7 days before until 7 days after the onset of the rash.

Infants with CRS may be infectious for months.
Funded vaccine A live attenuated vaccine (MMR II), containing measles, mumps and rubella viruses.
Funded vaccine indications and schedule Children at ages 15 months and 4 years.

Adults who are susceptible to 1 or more of measles, mumps and rubella.

For (re-)vaccination following immunosuppression (seek specialist advice).
Serological testing Rubella is rare in New Zealand, and so:
  • routine serological testing of children after vaccination is not indicated
  • women planning to get pregnant should know their rubella immunity status – serological testing for rubella immunity is part of routine antenatal care
  • ​pregnant women with a rubella antibody level <10 IU/mL should avoid contact with known cases of rubella, and should receive MMR after delivery (if they have not already received 2 doses of a rubella-containing vaccine).
Vaccine efficacy/effectiveness Highly effective with a 2-dose schedule; protection lasts at least 20 years and may be considerably longer.
Egg allergy Egg allergy, including anaphylaxis, is not a contraindication for MMR vaccine.
Adverse events to vaccine MMR vaccine is generally well tolerated. The risk of adverse reactions to MMR vaccine is low compared to the risk of complications from rubella disease.