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A Potential Rubella Problem

Henry H. Balfour, Jr, MD; Don P. Amren, MD

Am J Dis Child. 1978;132(6):573-577.

Abstract
• One hundred sixty-eight children immunized by one suburban Minneapolis clinic during routine pediatric visits had serum antibodies measured to determine the efficacy of rubella (HPV77 DE5 strain), measles (Edmonston B and Moraten strains), and mumps (Jeryl Lynn strain) vaccines. Serologic failure rates at the mean postvaccination times tested were as follows: rubella, 36% (4.7 years); measles, 18% (6.5 years); and mumps, 9% (4.5 years). Antibody titers shortly after vaccination were not done, so seronegative subjects may never have responded or their titers may have declined with time; our rubella data suggest the former. Children vaccinated with rubella and measles at <14 months of age had higher failure rates than those vaccinated at a later age. This supports postponement of rubella and measles vaccinations until at least 15 months of age. In addition to current measles reimmunization policies, consideration also should be given to reimmunizing girls who were given rubella vaccine at <14 months of age. Twenty-four percent (19/79) of children vaccinated with HPV77 DE5 strain rubella at 14 months or older had rubella hemagglutination-inhibiting titers <8. This is disturbing and, if confirmed by others, would prompt the use of a different strain of rubella vaccine for routine immunization.

(Am J Dis Child 132:573-577, 1978)

Author Affiliations
From the Virology Section, Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, and Pediatrics, University of Minnesota (Dr Balfour), and the Pediatric Department, St Louis Park Medical Center (Dr Amren), Minneapolis.

Footnotes
Reprint requests to Box 437 Mayo, University of Minnesota Health Sciences Center, Minneapolis, MN 55455 (Dr Balfour).

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