Rubella - Health Freedom Ireland

Disease	Risk of getting	Risk of death
rubella	rubella declared eradicated in 2016. Last case of CRS in 2009.	Pre vaccine (1988) – negligible

What is rubella?

Rubella, or German measles, is a generally mild viral infection that causes a low-grade fever and a red rash starting on the face and spreading downwards, lasting around three days. The incubation period is typically 14-17 days. While rubella is harmless in children and often provides lifelong immunity, it poses significant risks for pregnant women, as it can cause congenital rubella syndrome (CRS) in the unborn child, leading to severe birth defects.

To prevent CRS, women of childbearing age are advised to check their immunity by testing for rubella antibodies.

The World Health Organization (WHO) officially declared rubella eradicated in the Americas in April 2015 [15] and in Ireland in April 2017 . This achievement also meant the eradication of Congenital Rubella Syndrome (CRS) in these regions, with the last reported case of CRS in Ireland occurring in 2009.

According to Harrison’s Principles of Internal Medicine :

”Rubella was once most frequent among children aged five to nine years, but with the advent of immunisation programs often directed primarily at this group as well as pre-schoolers, a greater proportion of cases is now being reported among older people (15-24 years).”

What is the risk of getting rubella or congenital rubella syndrome (CRS) in Ireland?

The risk for all ages of getting rubella in Ireland during the ten years between 2011 and 2020 was approximately 1 in 2.4 million (0.000004%). The last case of Congenital Rubella Syndrome was in 2009.

What is the risk of death from rubella in Ireland?

Deaths from rubella have always been extremely rare before and after the vaccine was introduced. There were two deaths in the decade before the rubella vaccine was introduced in 1971 and two deaths in the decade before the MMR vaccination was introduced in 1988. In the last forty years there have been a total of four deaths across all age groups.

What vaccines are recommended on the childhood schedule for rubella in Ireland?

The HSE recommend the measles-mumps-rubella (MMR) vaccine for babies in Ireland at 12 months with a second dose given in Junior Infants. The MMR vaccine was first introduced in 1988. There are two vaccines available, both of which are combination, live, attenuated (weakened) virus vaccines.

M-M-RvaxPro manufactured by Merck Sharp & Dohme or
Priorix manufactured by GlaxoSmithKline

Does the MMR vaccine guarantee protection against rubella?

No – you may still get rubella even if vaccinated.

Are the MMR vaccines safe?

All vaccines come with risks, some very serious. Below is a summary of the risks from the MMR vaccines as listed on the patient information leaflets.

M-M-RvaxPro summary of risks (full details can be found here)

Risks from each dose of MMR vaccine M-M-RvaxPro

2 doses recommended, at 12 months and Junior infants (as per M-M-RvaxPro patient information leaflet June 2024)

Observed side effects post administration of M-M-RvaxPro (post marketing)
Aseptic meningitis (fever, feeling sick, vomiting, headache, stiff neck, and sensitivity to light); swollen testicles; infection of the middle ear; inflamed salivary glands; atypical measles (described in patients who received a killed measles virus vaccine, usually given before 1975). Swollen lymph nodes. Bruising or bleeding more easily than normal. Severe allergic reaction that may include difficulty in breathing, facial swelling, localised swelling, and swelling of the limbs. Irritability. Seizures (fits) without fever; seizures (fits) with fever in children; walking unsteadily; dizziness; illnesses involving inflammation of the nervous system (brain and/or spinal cord). An illness consisting of muscle weakness, abnormal sensations, tingling in the arms, legs, and upper body (Guillain-Barré syndrome). Headache; fainting; nerve disorders which can cause weakness, tingling, or numbness; eye nerve disturbances. Discharge and itching of the eyes with crusting of eyelids (conjunctivitis). Inflammation of the retina (in the eye) with changes in sight. Deafness. Cough; lung infection with or without fever. Feeling sick (nausea). Itching; inflammation of the fatty tissue under the skin; red or purple, flat, pinhead spots under the skin; hardened, raised area of the skin; serious illness with ulcers or blistering of the skin, mouth, eyes, and/or genitals (Stevens-Johnson syndrome). Joint pain and/or swelling (usually transient and rarely chronic); muscle pain. Burning and/or stinging of short duration at the injection site; blisters and/or hives at the injection site. Generally feeling unwell (malaise); swelling; soreness. Inflammation of blood vessels.

Observed side effects post administration of M-M-RvaxPro (post marketing)

Aseptic meningitis (fever, feeling sick, vomiting, headache, stiff neck, and sensitivity to light); swollen testicles; infection of the middle ear; inflamed salivary glands; atypical measles (described in patients who received a killed measles virus vaccine, usually given before 1975). Swollen lymph nodes. Bruising or bleeding more easily than normal. Severe allergic reaction that may include difficulty in breathing, facial swelling, localised swelling, and swelling of the limbs. Irritability. Seizures (fits) without fever; seizures (fits) with fever in children; walking unsteadily; dizziness; illnesses involving inflammation of the nervous system (brain and/or spinal cord). An illness consisting of muscle weakness, abnormal sensations, tingling in the arms, legs, and upper body (Guillain-Barré syndrome). Headache; fainting; nerve disorders which can cause weakness, tingling, or numbness; eye nerve disturbances. Discharge and itching of the eyes with crusting of eyelids (conjunctivitis). Inflammation of the retina (in the eye) with changes in sight. Deafness. Cough; lung infection with or without fever. Feeling sick (nausea). Itching; inflammation of the fatty tissue under the skin; red or purple, flat, pinhead spots under the skin; hardened, raised area of the skin; serious illness with ulcers or blistering of the skin, mouth, eyes, and/or genitals (Stevens-Johnson syndrome). Joint pain and/or swelling (usually transient and rarely chronic); muscle pain. Burning and/or stinging of short duration at the injection site; blisters and/or hives at the injection site. Generally feeling unwell (malaise); swelling; soreness. Inflammation of blood vessels.

Risk Category	Observed Side Effects
up to 1 in 100 (1%)	Nasal congestion and sore throat; upper respiratory tract infection or viral infection; runny nose. Crying. Diarrhoea, vomiting. Hives. Injection-site rash.
up to 1 in 10 (1% to 10%)	Rash (including measles-like rash). Injection-site bruising.
> 1 in 10 (10%)	Fever (38.5°C or higher). Injection-site redness; injection-site pain; injection-site swelling.

Priorix Summary of risks (full details can be found here)

Risks from each dose of MMR vaccine Priorix
2 doses recommended, at 12 months and Junior infants (as per Priorix patient information leaflet Sept 2023)

Observed side effects post administration of Priorix (post marketing)
Joint and muscle pain • Punctual or small spotted bleeding or bruising more easily than normal due to a drop in platelets • Sudden life-threatening allergic reaction • Infection or inflammation of the brain, spinal cord and peripheral nerves resulting in temporary difficulty when walking (unsteadiness) and/or temporary loss of control of bodily movements, inflammation of some nerves, possibly with pins and needles or loss of feeling or normal movement (Guillain-Barré syndrome) • Narrowing or blockage of blood vessels • Erythema multiforme (symptoms are red, often itchy spots, similar to the rash of measles, which starts on the limbs and sometimes on the face and the rest of the body) • Measles and mumps-like symptoms (including transient, painful swelling of the testicles and swollen glands in the neck).

Observed side effects post administration of Priorix (post marketing)

Joint and muscle pain • Punctual or small spotted bleeding or bruising more easily than normal due to a drop in platelets • Sudden life-threatening allergic reaction • Infection or inflammation of the brain, spinal cord and peripheral nerves resulting in temporary difficulty when walking (unsteadiness) and/or temporary loss of control of bodily movements, inflammation of some nerves, possibly with pins and needles or loss of feeling or normal movement (Guillain-Barré syndrome) • Narrowing or blockage of blood vessels • Erythema multiforme (symptoms are red, often itchy spots, similar to the rash of measles, which starts on the limbs and sometimes on the face and the rest of the body) • Measles and mumps-like symptoms (including transient, painful swelling of the testicles and swollen glands in the neck).

Risk Category	Observed Side Effects
up to 1 in 1000 (0.1%)	Convulsions accompanying high fever • Allergic reactions
up to 1 in 100 (1%)	Infection of the middle ear • Swollen lymph glands (glands in the neck, armpit or groin) • Loss of appetite • Nervousness • Abnormal crying • Inability to sleep (insomnia) • Redness, irritation and watering of the eyes (conjunctivitis) • Bronchitis • Cough • Swollen parotid glands (glands in the cheek) • Diarrhoea • Vomiting
up to 1 in 10 (1% to 10%)	Pain and swelling at the injection site • Fever higher than 39.5°C • Rash (spots) • Upper respiratory tract infection
> 1 in 10 (10%)	Redness at the injection site • Fever of 38°C or higher