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Vaccine Preventable Disease Control
County of Los Angeles
Department of Public Health
Vaccine Preventable Disease Control Program
3530 Wilshire Blvd. Suite 700
Los Angeles, CA 90010
Phone: (213) 351-7800
Email: ip@ph.lacounty.gov
Symptoms:
Complications:
The most serious complication from rubella infection is the harm it can cause a pregnant person’s developing baby. Serious birth defects are more common if a pregnant person is infected early in their pregnancy, especially in the first trimester. These severe birth defects are known as congenital rubella syndrome (CRS) and may result in infants being born with one or more of the following conditions:
If you think you or someone in your family may have symptoms or been exposed to rubella, contact your health care provider.
Rubella spreads when an infected person coughs or sneezes. A person with rubella may spread the disease to others up to one week before the rash appears and remain contagious up to 7 days after.
If a pregnant person is infected with rubella, they can pass it on to their developing baby. See Pregnancy and Rubella page to learn more.
Rubella vaccination is the best way to prevent getting rubella. One dose of the MMR or MMRV vaccine is about 97% effective at preventing rubella.
Rubella can be prevented with MMR or MMRV vaccines. California requires children enrolling in school or childcare receive at least one dose of rubella-containing vaccine.
The CDC recommends that children receive two doses of MMR or MMRV:
Adults who are unvaccinated or are unsure of their vaccination status should get at least one dose of MMR vaccine.
Certain adults may need 2 doses. Adults who are going to be in a setting that poses a high risk for measles or mumps transmission should make sure they have had two doses separated by at least 28 days. These include:
Women of childbearing age who are planning to become pregnant should check with their doctor to make sure they’re vaccinated before getting pregnant.
If you are unsure about your vaccine status, review your vaccine records and talk with your doctor about getting vaccinated.
There are many places to get the MMR or MMRV vaccine. If you have insurance, talk to your doctor or check with your local pharmacy to see what vaccines are offered. Most health insurances cover the cost of all recommended vaccines for children and adults.
If you are uninsured or underinsured, there are programs available to help cover the cost of vaccines. Children who are 18 years of age or younger are eligible to receive vaccines at no cost through the Vaccines for Children (VFC) Program if they are:
Click to see if your child is eligible to receive VFC vaccines: English | Spanish
Uninsured or underinsured adults can access free or low cost vaccines at select clinics enrolled in the Vaccines for Adults (VFA) program. For more information on who is eligible, read VFA Eligibility Based on Insurance Status. You can use the following resources for more information on locating clinics:
You can also dial 2-1-1 for a list of free or low cost vaccine clinics. This includes Vaccines for Children (VFC) provider locations that serve Medi-Cal eligible children and uninsured or underinsured adults. Learn more about specific vaccine information for different age groups:
Are you not sure if you have been vaccinated against rubella or you can’t find your vaccine records?
If you need official copies of your vaccine records, or if you need to update your personal records:
Consider rubella in unvaccinated patients who recently traveled internationally or a person who was exposed to a confirmed rubella case. Rubella presents nonspecifically with the following symptoms:
Rubella is a mild viral illness, but it's very infectious and can lead to Congenital Rubella Syndrome (CRS), which can cause structural birth defects affecting the eyes and heart. When rubella infection occurs during pregnancy, especially during the first trimester, complications include miscarriages, and fetal deaths/stillbirths. At birth, infants may have signs and symptoms of CRS, including:
CRS was eliminated from the United States in 2004, but cases can still be imported by a pregnant person who contracts rubella in an endemic country. Although rare, CRS can occur when a susceptible pregnant person acquires a mild or asymptomatic rubella infection early in pregnancy, and fetal anomalies are later noted on ultrasound or at birth. Maternal infection beyond 18 weeks gestation may result in congenital rubella infection (CRI) only and not signs and symptoms of CRS.
Universal childhood vaccine is important to eliminate community transmission of rubella and thus prevent acquisition during early pregnancy.
Additional details regarding rubella infection in pregnancy, can be found here.
If a commercial lab cannot perform testing, please call the Los Angeles County Department of Public Health Vaccine-Preventable Disease Control (VPDC) Program at 213-351-7800 to arrange testing through the Public Health Laboratory (PHL). See below for instructions.
CDC’s Advisory Committee on Immunization Practices (ACIP) recommends that persons who do not have presumptive evidence of immunity should get vaccinated. Vaccination is the best way to prevent rubella and complications, such as CRS, from disease.
MMR and MMRV Vaccine Recommendations
| Vaccine Type | Vaccine Brand & Dosage | 1st Dose | 2nd Dose | Min. Interval between doses | Preferred Route | Preferred Injection Site |
|---|---|---|---|---|---|---|
| MMR (Measles, Mumps and Rubella) | PRIORIX (GlaxoSmithKline) and M-M-R II (Merck) (0.5 mL) | 12-15 months of age | 4-6 years of age | 28 days after the first dose | *PRIORIX: administered by the subcutaneous route
only |
*Preferred injection site in small children is
the anterolateral aspect of the thigh |
| MMRV (Measles, Mumps, Rubella, Varicella) | ProQuad (0.5 mL) | 12 -15 months of age | 4 -6 years of age | 3 months after first dose | *ProQuad may be administered by the subcutaneous or intramuscular route | *The posterior triceps aspect of the upper arm is the preferred site for older children and adolescents |
* MMR (M-M-R II and PRIORIX) are fully interchangeable for all indications for which MMR vaccination is recommended.
* MMRV (ProQuad) vaccine is only licensed for use in children 12 months through 12 years of age.
* MMRV (ProQuad) may be given at the same time as other vaccines.
* Pregnancy is a contraindication to vaccination with live virus vaccines, including MMR vaccines. ACIP recommends that pregnancy be avoided for 1 month following receipt of MMR vaccine.
Proper vaccine storage and handling practices play an important role. For general recommendations and guidance access the Vaccine Storage and Handling Toolkit.
Please contact the County of Los Angeles Dept. of Public Health Vaccine-Preventable Disease Control Program to report a case or obtain technical assistance with specimen collection or completion of forms for the reporting of rubella or CRS. Consultation is required before sending specimens to the Public Health Laboratory.
Report suspected or confirmed rubella cases within 7 calendar days from identification by electronic transmission (email or digital fax) or telephone (IAW Title 17, California Code of Regulations (CCR), Section 2500).
Documents to include:
CRS cases should also be reported to the Vaccine Preventable Disease Control Program within 7 calendar days from identification. Submit the following documentation:
Weekday Telephone (8:30 AM to 5:00 PM): 213-351-7800
After Hours: Call 213-974-1234
Email: vpdc@ph.lacounty.gov
Fax: 213-351-2782
Click here for more information on reporting a Vaccine Adverse Event.
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Public Health has made reasonable efforts to provide accurate translation. However, no computerized translation is perfect and is not intended to replace traditional translation methods. If questions arise concerning the accuracy of the information, please refer to the English edition of the website, which is the official version.
