Rubella

Per Wikipedia:  “Rubella, also known as German measles or three-day measles, is an infection caused by the rubella virus. This disease is often mild with half of people not realizing that they are infected. A rash may start around two weeks after exposure and last for three days. It usually starts on the face and spreads to the rest of the body. The rash is sometimes itchy and is not as bright as that of measles. Swollen lymph nodes are common and may last a few weeks. A fever, sore throat, and fatigue may also occur. In adults joint pain is common. Complications may include bleeding problems, testicular swelling, and inflammation of nerves. Infection during early pregnancy may result in a child born with congenital rubella syndrome (CRS) or miscarriage. Symptoms of CRS include problems with the eyes such as cataracts, ears such as deafness, heart, and brain. Problems are rare after the 20th week of pregnancy.

“Rubella is usually spread through the air via coughs of people who are infected. People are infectious during the week before and after the appearance of the rash. Babies with CRS may spread the virus for more than a year. Only humans are infected. Insects do not spread the disease. Once recovered, people are immune to future infections. Testing is available that can verify immunity. Diagnosis is confirmed by finding the virus in the blood, throat, or urine. Testing the blood for antibodies may also be useful.”

Rubella is an interesting disease not in that it is deadly, or even more than mildly uncomfortable outside of exceptionally rare cases, it’s interesting in that the risk it poses is to third parties:  pregnant women and their unborn children.  According to the CDC, the last major rubella epidemic in the US caused 12.5 million infections, 11,000 miscarriages, 2100 infant deaths, and 20,000 birth defects (congenital rubella syndrome).  This is undeniably tragic, and results in more harm than most other diseases children are vaccinated for combined.

On the other hand, according to the CDC, there are less than 10 cases of rubella in the US each year, and since 2012 all cases of rubella were caused by the infected party traveling outside of the US.  For those individuals that don’t intend to travel internationally (rubella is considered to be eradicated in the western hemisphere, though there are still occasional outbreaks in South and Central America), there is virtually zero risk of infection regardless of immunization status.

Vaccine Statistics

When debating informed consent, it is important that people calculate the risk versus the reward for all options.  Here are some facts, according to VAERS and the CDC.

• Since 2000, there have been no deaths from rubella in the US.
• Since 2000, there have been at least 122 deaths reported to VAERS associated with the rubella vaccine.
• Since 2000, there have been 62,287 adverse events reported to VAERS, with the vast majority of them falling between the ages of 1-5 years.

With no other data, it is clear that children face a greater risk of death from the rubella vaccine than they do from rubella itself, if it assumed that that child is considered in isolation.  When the bigger picture is looked at, the numbers get fuzzier.  Since 2000, there have been an average of 3.8 million live births in the US annually.  With 92% vaccination rates across the country, this equates to approximately 3.5 million children being vaccinated per year, leaving the odds of death at approximately 1 in 515,000 from receiving the rubella vaccine.  If the FDA’s assessment of reporting compliance is correct (<1%), these odds could be as low as 1 in 5150, making it infinitely more risky to get the vaccine than the disease.  The problem with calculation, however, is that we simply do not know the true number of deaths attributable to the rubella vaccine due to our faulty reporting system.  Other statistics (based upon estimated numbers of doses administered per the above calculation) reported since 2000 (rate reported/rate possible per FDA):

•  665 immediately life threatening complications (1 in 95,000/1 in 950)
• 646 permanent disabilities (1 in 97,500/1 in 975)
• 2391 hospitalizations or extensions of hospitalization (1 in 26000/1 in 260)
• 20,666 emergency room or office visits related to complications (1 in 3050/1 in 31)

Some of the possible rates per the FDA are too chilling to want to believe, and to be perfectly honest, we are skeptical of them.  This is the greatest problem with estimating risk versus reward when real numbers are deliberately obscured.

According to Merck, only 99% of children develop antibodies to rubella post-vaccination.  Of all commercially available vaccines, the rubella vaccine indisputably has the highest conversion rate.   With rare exceptions, those vaccinated will be conferred 12+ years of immunity from rubella.

Vaccine Safety

Vaccine Type:  live attenuated/potential vector of transmission*

Pregnancy Class:  C

This section will reference the product insert from Merck’s MMR II vaccine.  It should be noted that measles vaccines (all types) are one of the few vaccines on the market that doesn’t use aluminum adjuvants.

Contraindications (do not vaccinate):

• Hypersensitivity to eggs, beef, gelatin, or neomycin
• Fever
• Immunosuppressed (steroids, etc.) or immunocompromised
• Pregnant, or may become pregnant within 3 months
• History of brain injury or family history of convulsions
• Thrombocytopenia (low platelet count)
• Reaction to previous administration of MMR

• Panniculitis, atypical measles, fever, syncope, headache, dizziness, malaise, irritability, vasculitis, pancreatitis, diarrhea, vomiting, parotitis, nausea, diabetes mellitus, thrombocytopenia, purpura, regional lymphadenopathy, anaphylaxis, bronchospasm,  arthritis, arthralgia, myalgia, polyneuritis, encephalitis, encephalopathy, measles inclusion body encephalitis, subacute sclerosing panecephalitis, Guillain-Barré Syndrome, acute disseminated encephalomyelitis, transverse myelitis, febrile convulsions, afebrile convulsions/seizures, ataxia, polyneuropathy, ocular palsies, paresthesia, aseptic meningitis, pneumonia, pneumonitis, sore throat, cough, rhinitis, Stevens-Johnson syndrome, erythema multiforme, urticaria, rash, pruritis, burning/stinging at injection site, Henoch-Schönlein purpura, acute hemorrhagic edema of infancy, nerve deafness, otitis media, retinitis, optic neuritis, papillitis, retrobulbar neuritis, conjunctivitis, epididymitis, orchitis, and death.

News:

•  Two infants die in Samoa immediately after receiving the MMR vaccine

Scientific Studies

• MMR-vaccinated children were 3.5 times more likely than unvaccinated children to be diagnosed with asthma (HR = 3.5) and 4.6 times more likely to be diagnosed with eczema (HR = 4.6).
• “Children having received measles, mumps, and rubella vaccination (MMR) showed an increased risk of rhinoconjunctivitis, whereas measles infection was associated with a lower risk of IgE-mediated eczema.”
• Children who never received an MMR vaccine had a significantly lower prevalence of allergies (OR = 0.67) compared to a control group.
• “The current findings indicate that there are clusters of cases of type 1 diabetes mellitus occurring 2-4 years post-immunization with the pertussis, MMR, and BCG (tuberculosis) vaccines.”
• Febrile seizures were nearly 3 times more likely to occur during the two weeks after MMR vaccination than at other times (RR = 2.75).
• “Ten percent of pediatricians and 21% of pediatric specialists claim they would not follow ]CDC] recommendations for future progeny.  Despite their education, physicians in this study expressed concern over the safety of vaccines.”
• This study analyzed the vaccination schedules of 34 developed nations and found that nations requiring the most vaccines tend to have the worst infant mortality rates.
• Adults who contracted chickenpox (varicella) as children were significantly protected against acute coronary events (OR = 0.67).  Each additional contagious disease contracted during childhood, such as measles, mumps, or rubella, increased the protective effect against acute coronary events by 14%.
• Baby monkeys that were given vaccines according to the CDC vaccination schedule had abnormalities in the region of the brain affecting social and emotional development.  The vaccinated primates had altered amygdala growth, associated with social and emotional development.  The vaccinated primates had a significant increase in total brain volume, a consistent finding in many children with autism.
• Children who were under-vaccinated due to parental choice had significantly lower rates of emergency department visits.
• Infants who received several vaccines concurrently were the most likely to be hospitalized or die.  This trend was more pronounced the younger the age of the child.
• Children were significantly more likely to be rushed to an ER or admitted to a hospital during the risk periods after vaccination with MMR at 12 months (RI = 2.04 on day 9) and 18 months (RI = 1.34 on day 12) than during the control periods.
• Measles, rubella, and chickenpox infections during childhood protect against many different types of cancer later in life.  Adults were significantly protected against non-breast cancers (genital, prostate, gastrointestinal, skin, lung, ear/nose/throat, and others) if they contracted measles (OR = 0.45), rubella (OR = 0.38) or chickenpox (OR = 0.62) earlier in life.
• Immune throbocytopenic purpura is an autoimmune disease that causes internal bleeding and can be life threatening.  ITP is 5 times more likely to occur after MMR vaccination (IRR = 5.48).  Children were twice as likely to have convulsions 6 to 11 days after MMR (RI = 2.07) and 7 times more likely to develop ITP 6 weeks after MMR (RI = 6.91) compared to the period prior to MMR.

Editor’s Opinion

In the US, there have been no native cases of rubella reported, and unless an individual has close contact with those that have recently traveled abroad or travels themselves, they bear virtually zero risk of contracting rubella.  Even ignoring the hundreds of thousands of reports from parents who claim their child regressed into autism after receiving the MMR vaccine, for these individuals, we do not recommend that anyone administer the rubella vaccine to their child in today’s society.

For women of childbearing age that have close contact with those that have recently traveled abroad or plan to travel abroad themselves, the decision becomes more complicated.  Single-disease vaccines for rubella are no longer available in the US.  If there is no chance that the woman will become pregnant during travel, we do not recommend that they receive the rubella vaccine.  If there is any chance that the woman intends to become pregnant in the near future or could become pregnant, we recommend that they are vaccinated no later than three months prior to possible conception.