Rubella Vaccine Administration and Schedule

Standard Schedule for Children

The Centers for Disease Control and Prevention recommends a first dose of rubella vaccine at 12-15 months of age and a second dose at 4-6 years of age, administered subcutaneously as 0.5 mL of reconstituted vaccine, preferably as part of the MMR combination vaccine 1, 2, 3
The American Academy of Pediatrics recommends that the minimum interval between doses is 4 weeks, though the recommended schedule spaces them further apart 4, 5
The vaccine is administered subcutaneously as a 0.5 mL dose, and it is preferably given as MMR combination vaccine rather than monovalent rubella vaccine 1, 2

For children in high-risk areas for measles transmission, the Centers for Disease Control and Prevention recommends initial MMR vaccination at 12 months of age 1, 2
Infants vaccinated with MMR before their first birthday should be revaccinated, as maternal antibodies may interfere with seroconversion 1, 6
During international travel, infants aged 6-11 months should receive a single dose of MMR, but this does not count toward the routine two-dose schedule 7
During measles outbreaks, infants aged 6-11 months should receive a single dose of MMR for protection 7

The Centers for Disease Control and Prevention recommends that MMR can be administered simultaneously with other vaccines at different anatomic sites 7, 5
If not administered simultaneously with other live vaccines, MMR should be given at least 28 days before or after another live vaccine 4, 5
Two MMR vaccines are currently available in the US and are considered fully interchangeable 7
Documentation of vaccination should be maintained in the patient's permanent medical record 1, 2

Older children who have not received rubella vaccine should be vaccinated promptly, with 2 doses recommended at least 4 weeks apart 1, 6, 7, 4
Adults born in 1957 or later should receive at least one dose of MMR vaccine unless they have documentation of vaccination or laboratory evidence of immunity 3

Greater than 95% of susceptible persons who receive a single dose of rubella vaccine develop antibody, with clinical efficacy studies showing >90% of vaccinees have protection against both clinical rubella and viremia for at least 15 years 6
Vaccine-induced protection is considered long-term, probably lifelong 6
Persons can be considered immune to rubella if they have documentation of laboratory evidence of immunity or adequate immunization with at least one dose of rubella vaccine on or after the first birthday 6, 8

The American College of Obstetricians and Gynecologists recommends that all women of childbearing age should be considered susceptible to rubella unless they have received at least one dose of MMR or have serologic evidence of immunity 3
MMR vaccine should be offered to all women of childbearing age who do not have acceptable evidence of rubella immunity 3
Vaccination of susceptible postpubertal females confers individual protection against rubella-induced fetal injury 1, 2

The Centers for Disease Control and Prevention recommends that MMR should not be administered to severely immunocompromised children 4
A personal or family history of seizures is a precaution for MMRV vaccination; in these cases, separate MMR and varicella vaccines are recommended 4

The American College of Physicians recommends that students in postsecondary educational institutions, healthcare personnel born in 1957 or later, international travelers, and household or close personal contacts of immunocompromised persons receive a complete 2-dose series with at least 4 weeks between doses, regardless of timing delays 9, 10
The American College of Physicians recommends that adults born in 1957 or later who are severely immunocompromised should not receive the MMR vaccine, and pregnant women should not receive the vaccine but can be vaccinated immediately postpartum if non-immune 9, 10

The American College of Physicians recommends verifying immunity through documentation of receipt of MMR vaccine, laboratory evidence of immunity or disease, or birth before 1957 (except for healthcare personnel, who should still be vaccinated regardless) 9, 10