Measles, Mumps, and Rubella - Centers for Disease Control and ...

Vol. 47 / No. RR-8 MMWR 17Women of Childbearing AgeMMR vaccine should be offered to all women of childbearing age (i.e., adolescentgirls and premenopausal adult women) who do not have acceptable evidence ofrubella immunity whenever they make contact with the health-care system. Opportunitiesto vaccinate susceptible women include occasions when their children undergoroutine examinations or vaccinations. The continuing occurrence of rubella amongwomen of childbearing age indicates the need to continue vaccination of susceptibleadolescent and adult women of childbearing age, and the absence of evidence of vaccineteratogenicity indicates that the practice is safe (102 ). Vaccination of susceptiblewomen of childbearing age should• be part of routine general medical and gynecologic outpatient care;• take place in all family-planning settings; and• be provided routinely before discharge from any hospital, birthing center, orother medical facility, unless a specific contraindication exists (see Precautionsand Contraindications).Outbreaks of rubella in the United States recently have occurred among women ofHispanic ethnicity, many of whom were born outside the fifty states. Efforts should bemade to ensure that all susceptible women of childbearing age, especially those whogrew up outside the fifty states in areas where routine rubella vaccination may notoccur, are vaccinated with MMR vaccine or have other acceptable evidence of immunity(Table 1). Ascertainment of rubella-immune status of women of childbearing ageand the availability of rubella vaccination should be components of the health-careprogram in places where the risks for disease exposure and transmission are substantial(e.g., day care facilities, schools, colleges, jails, and prisons).No evidence indicates that administration of rubella-containing vaccine virus to apregnant woman presents a risk for her fetus, although such a risk cannot be excludedon theoretical grounds. Therefore, women of childbearing age should receive rubellacontainingvaccines (i.e., rubella, MR, or MMR vaccine) only if they state that they arenot pregnant and only if they are counseled not to become pregnant for 3 months aftervaccination. Because of the importance of protecting women of childbearing ageagainst rubella, reasonable practices in any immunization program include a) askingwomen if they are pregnant, b) not vaccinating women who state that they are pregnant,c) explaining the potential risk for the fetus to women who state that they are notpregnant, and d) counseling women who are vaccinated not to become pregnant duringthe 3 months following MMR vaccination.Routine Vaccination of Women Who Are Not Pregnant. Women of childbearing agewho do not have documentation of rubella vaccination or serologic evidence of rubellaimmunity should be vaccinated with MMR, if they have no contraindications tothe vaccine. Birth before 1957 is not acceptable evidence of immunity for women whocould become pregnant (Table 1). The use of MMR vaccine provides the potential additionalbenefit of protection against measles and mumps. Serologic testing beforevaccination is not necessary and might present a barrier to timely vaccination. Routinetesting for rubella antibody during clinic visits for routine health care, premarital