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September 17, 1973

Inadvertent Rubella Vaccination of Pregnant WomenFetal Risk in 215 Cases

JAMA. 1973;225(12):1472-1476. doi:10.1001/jama.1973.03220400018004

Two hundred fifteen cases of inadvertent rubella vaccination in early pregnancy or shortly before conception have been studied to determine the risk of fetal infection with rubella vaccine-like virus (RVV). Of the 215 women, 184 (86%) did not have prevaccination sero-immunity screening. Only 24 women (11%) were known to be susceptible prior to vaccination. One hundred seven (50%) of the pregnancies ended with induced abortions, 12 (5%) with spontaneous abortions, and 96 (45%) with live births. None of the live-born infants had serologic or clinical evidence of congenital rubella; however, RVV was isolated from abortion specimens in seven cases, three of which had isolates from fetal tissue. The similarities between RVV and wild rubella virus infection of decidual, placental, and fetal tissue strongly suggest that RVV poses a definite hazard to the fetus.