Rubella Virus Vaccine Dosage

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Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Rubella Prophylaxis

0.5 mL subcutaneously into the outer aspect of the upper arm.

Usual Pediatric Dose for Rubella Prophylaxis

>= 1 year: 0.5 mL subcutaneously into the outer aspect of the upper arm. Primary vaccination is recommended at age 12 to 15 months.

Revaccination with measles/mumps/rubella vaccine is recommended before entry into elementary school.

Renal Dose Adjustments

No adjustment recommended

Liver Dose Adjustments

No adjustment recommended

Precautions

Rubella virus vaccine is not recommended for infants less than 12 months of age because they may retain maternal rubella neutralizing antibodies that may interfere with the immune response.

There is currently no evidence that live rubella virus vaccine given after exposure to natural rubella virus will prevent illness. However, there is no contraindication to vaccinating children already exposed to natural rubella.

Rubella vaccine is contraindicated in patients who have had signs of hypersensitivity after a previous dose of this vaccine or of the monovalent vaccines; who are allergic to gelatin or other trace substances (neomycin) which may be present in the vaccine; patients on immunosuppressive therapy (except replacement corticosteroid therapy); patients with blood dyscrasias, leukemia, lymphomas, or other bone marrow or lymphatic system malignant neoplasms; primary and acquired immunodeficiency states, including patients with AIDS/HIV, cellular immune deficiencies, and hypo- and dysgammaglobulinemias, persons with a family history of congenital or hereditary immunodeficiency, unless the potential vaccinee's immune competence has been demonstrated.

According to the manufacturer's labeling, febrile illness is considered a contraindication to the vaccine; however, the Advisory Committee on Immunization Practices recommends that all vaccines can be administered to individuals with minor illnesses with or without low-grade fever.

Rubella vaccine contains human albumin and carries the possibility for transmission of blood-borne viral agents and theoretically, the variant Creutzfeldt-Jakob disease (vCJD) agent. The risk of transmission of known blood-borne viruses is considered to be low because of the purification procedure used for immune globulin products; however, no method has been totally effective in removing all risk and the potential exists for the presence of unknown infectious agents. Physicians should report to the manufacturer all infections thought to be transmitted by this product.

According to the American Academy of Pediatrics, a history of contact dermatitis to neomycin is not a contraindication; however, individuals with a history of anaphylaxis to topical or systemic neomycin should not receive this vaccine.

Existing thrombocytopenia may become more severe after vaccination. Vaccinees who develop thrombocytopenia after the first dose of measles/mumps/rubella vaccine or its components may develop thrombocytopenia with subsequent doses. Serologic status may be evaluated to determine whether or not additional doses of vaccine are needed. The potential risks and benefits should be evaluated before considering vaccination.

Anaphylaxis may occur, even in patients with no previous hypersensitivity to the vaccine ingredients. Epinephrine and other medications and equipment should be readily available to treat anaphylactic or severe allergic reactions.

The vaccine should not be injected into a blood vessel.

Children and young adults who are HIV-infected but not immunosuppressed may be vaccinated. However, vaccinees should be monitored closely for disease because immunization may not be as effective as for uninfected persons.

Vaccination should be deferred for at least 3 months after administration of blood or plasma transfusions or immune globulins.

Transmission of live attenuated rubella virus from vaccinees to susceptible contacts has not been reported. Small amounts of live attenuated rubella virus are excreted from the nose or throat in most vaccinees for 7 to 28 days. Transmission through close personal contact is theoretically possible, but is not considered a significant risk.

Persons with active untreated tuberculosis should not be vaccinated.

Vaccination may not result in protection in 100% of vaccinees.

The Advisory Committee on Immunization Practices advises that live-virus vaccines may be given to patients with leukemia in remission if they have not received chemotherapy for at least 3 months, and to patients receiving nonimmunosuppressive doses of corticosteroids (i.e., short-term, low to moderate systemic doses, long-term alternate-day therapy with low to moderate doses of short-acting steroids, topical steroids, and intra-articular, bursal, or tendon injections.)

Health care providers should report any allergic or unusual adverse reactions to the Vaccine Adverse Event Reporting System (VAERS) at 1-800-822-7967 (USA) and the manufacturer.

Dialysis

No adjustment recommended

Other Comments

Rubella vaccine should be administered 1 month apart from other live virus vaccines. Immune globulin should not be given concurrently.

The lyophilized vaccine should be refrigerated. It should be protected from light to maintain potency. Reconstituted vaccine should be refrigerated in a dark place and discarded if not used within 8 hours.

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