Some current issues relating to rubella vaccine.

At the time of licensure in 1969, available data indicated that rubella vaccines were safe, noncommunicable, and effective. Since vaccine virus could cross the placenta and infect the fetus, cautious use of the vaccines in childbearing-age women was recommended. Over the past 15 years, additional information about the vaccines has been accumulated. This article provides an update of data on (1) the risk and degree of joint symptoms following vaccination and revaccination, (2) the duration of vaccine-induced immunity, (3) the protective effect of low levels of vaccine-induced antibody, and (4) the risks to the fetus following maternal vaccination. The data support continued vaccination of all young children as well as increased efforts to vaccinate susceptible adolescents and young adults, especially women. Only by more effective vaccination of the latter can elimination of congenital rubella syndrome be hastened.