A woman received a rubella-containing vaccine at 6 weeks of gestation before her pregnancy was recognized. She is anxious about congenital rubella syndrome. What is the correct counseling?
- A Pregnancy should be terminated because the vaccine strain is highly teratogenic
- B The vaccine virus is teratogenic only after the first trimester
- C Inadvertent vaccination in pregnancy is not an indication for termination, as no case of vaccine-induced CRS has been documented ✓
- D Immunoglobulin should be administered immediately to neutralize the vaccine virus
Correct answer: C. Inadvertent vaccination in pregnancy is not an indication for termination, as no case of vaccine-induced CRS has been documented
Explanation
Although rubella vaccine is contraindicated in pregnancy on theoretical grounds, decades of registry follow-up of women inadvertently vaccinated around conception have found no case of congenital rubella syndrome attributable to the vaccine strain. Termination is not indicated. Giving immunoglobulin after vaccination is ineffective and not recommended. The theoretical risk cited is far below the background risk of congenital anomalies.
Reference: Red Book: Report of the Committee on Infectious Diseases, 32nd ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.