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# Rubella vaccine

Live attenuated rubella virus (RA 27/3), given as MMR or MR. Its main purpose is to prevent congenital rubella syndrome.

Updated 2026-11-01

- Class: [Viral vaccines](https://durgical.com/en/pharmacology/classes/viral-vaccines/)
- Target: Rubella virus envelope glycoprotein E1
- ATC code: J07BJ
- WHO Model List of Essential Medicines

Also called: MMR (triple viral), MR (measles-rubella)

◆**Rubella virus envelope glycoprotein E1**Rubella vaccine

ⓘ The figure shows rubella virus E1 in its post-fusion form; the live vaccine induces antibodies against E1 and the other envelope proteins.

**Target in 3D:** Rubella virus envelope glycoprotein E1. PDB structure 4ADG (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/4ADG) · Drag to rotate · pinch to zoom

## Mechanism of action

Rubella is usually mild, but infection early in pregnancy can cause miscarriage, stillbirth or congenital rubella syndrome (deafness, cataracts and other eye defects, congenital heart disease). The vaccine protects the future fetus by making women immune before pregnancy and by stopping circulation of the virus. The Americas eliminated endemic rubella and congenital rubella syndrome in 2009.

- Attenuated RA 27/3 virus is injected within MMR or MR
- Antibodies form against the envelope glycoproteins
- Immune women do not pass rubella to the fetus
- High coverage stops circulation and prevents congenital rubella

## Pharmacokinetics

**Onset and duration**
Protection follows a single response to the live vaccine; it is given as part of the two-dose MMR series

## Indications

- Routine childhood vaccination as MMR (triple viral)
- Susceptible women of childbearing age, including after delivery or abortion
- Colombia (MinSalud): people born between 2009 and 2019, and health, tourism and transport workers without a record, receive measles-rubella (MR) vaccine

## Adverse effects

### Common

- Arthralgia or arthritis, mainly in adult women
- Fever and rash

### Serious (rare, important)

- Thrombocytopenia (rare)
- Anaphylaxis (very rare)

## Contraindications

- Pregnancy
- Severe immunosuppression
- Severe allergic reaction to a previous dose or a component

## Key interactions

**Antibody-containing blood products**
They neutralise the live vaccine virus: vaccination is delayed for months after them

**Yellow fever vaccine**
Given together, the rubella response can be lower; when possible they are separated by one month

## What is monitored

- Rubella immunity in women before pregnancy
- Joint symptoms in adult women after vaccination

## Administration and safety

- Given as MMR or MR: lyophilised, reconstitute with the supplied diluent
- Subcutaneous route
- Check that the woman is not pregnant
- Record the batch and product

## Nursing care

- Ask about pregnancy before vaccinating women of childbearing age
- Advise avoiding pregnancy for four weeks after vaccination
- Offer vaccination after delivery to susceptible women
- Warn adult women about possible joint pain

## Pregnancy and breastfeeding

Contraindicated in pregnancy and pregnancy is avoided for four weeks afterwards; congenital rubella syndrome has not been seen after inadvertent vaccination, so it is not a reason to end a pregnancy.

## Memory aid

"Rubella is mild for the mother, terrible for the fetus": vaccinate before pregnancy, never during; wait four weeks to conceive.

## Test yourself

Think of the answer, then tap the question to see it.

## What are three features of congenital rubella syndrome?

Deafness, eye defects such as cataracts, and congenital heart disease.

## When is fetal risk from maternal rubella highest?

With infection in the first 12 weeks of pregnancy.

## What is advised after inadvertent rubella vaccination in pregnancy?

Individual counselling; it is not a reason to end the pregnancy because the fetal risk appears extremely low.

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## Related drugs

- [Measles vaccine](https://durgical.com/en/pharmacology/measles-vaccine/)
- [Mumps vaccine](https://durgical.com/en/pharmacology/mumps-vaccine/)

[← Back to the class: Viral vaccines](https://durgical.com/en/pharmacology/classes/viral-vaccines/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Chapter 20: Rubella | Pink Book | CDC](https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-20-rubella.html) (Centers for Disease Control and Prevention, 2021); [Lineamiento Técnico y Operativo de la Primera Jornada Nacional de Vacunación](https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/PP/PAI/lineamientos-t%C3%A9cnicos-primera-jornada-nacional-vacunaci%C3%B3n-2026.pdf) (Ministerio de Salud y Protección Social (Colombia), 2026); [Yellow Fever | CDC Yellow Book™](https://www.cdc.gov/yellow-book/hcp/travel-associated-infections-diseases/yellow-fever.html) (Centers for Disease Control and Prevention, 2025).

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Representative model, for educational purposes only.

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