Vaksin Rubella

Anak-anak dalam program imunisasi rutin (biasanya sebagai vaksin MMR), wanita usia subur yang belum divaksinasi.

Severe allergic reaction to previous dose, neomycin, or any component. Pregnancy — live vaccine; avoid conception for ≥4 weeks after vaccination (previously 3 months, revised to 4 weeks based on accumulated safety data). Severe immunodeficiency: symptomatic HIV (CD4 <200), active leukemia/lymphoma, immunosuppressive therapy, congenital immunodeficiency. Moderate to severe acute illness (defer).

Very common: injection site pain (15–25%). Common: low-grade fever (5–15%), transient rash (5%, typically 7–10 days post-vaccination), lymphadenopathy. Joint symptoms (arthralgia/transient arthritis): 25% in adult women (rare in children and men) — onset 1–3 weeks post-vaccination, self-limiting over days to weeks. Rare: thrombocytopenic purpura (1/25,000), peripheral neuritis. Very rare: chronic arthropathy not confirmed to be causally related.

Single 0.5 mL dose, subcutaneous injection. Part of routine childhood schedule as MMR (12–15 months, 4–6 years). Standalone: single dose for catch-up in non-immune adults. Administered SC in deltoid or anterolateral thigh. Reconstitute lyophilized vaccine with supplied diluent; use within 8 hours.

Single dose: 95–100% seroconversion rate. Immunity is considered lifelong after single dose (unlike measles, rubella antibodies persist reliably). Effectiveness of rubella-containing vaccines: >97% against rubella, near 100% against CRS when vaccinated before pregnancy.

Store at +2°C to +8°C (or -20°C for long-term). Protect from light (photosensitive). Reconstituted vaccine: use within 8 hours, store at +2°C to +8°C. Diluent: do NOT freeze.

Same-day administration with other live vaccines is acceptable (MMR component rule). If not given same day, wait ≥28 days before another live injectable vaccine. Can be given with inactivated vaccines at any interval. Blood products: defer vaccination ≥3 months after immunoglobulin or blood transfusion (may reduce response). Tuberculin skin test: may be suppressed for 4–6 weeks after rubella vaccination.

CONTRAINDICATED in pregnancy (live vaccine). However, inadvertent vaccination is NOT an indication for pregnancy termination — no confirmed CRS cases from vaccine strain. Advise ≥4 weeks contraception post-vaccination. Breastfeeding: safe (vaccine virus isolated in breast milk but no disease in breastfed infants).

Part of routine childhood schedule via MMR (12–15 months + 4–6 years). Standalone rubella vaccine: limited pediatric use; prefer MR or MMR. Children ≥6 months: can receive MMR early for outbreak protection (dose before 12 months does not count for routine series).

Advise women of childbearing age to avoid pregnancy for ≥4 weeks post-vaccination. If inadvertently given in pregnancy, counsel that registry data shows NO confirmed cases of CRS from vaccine strain (CDC registry: >1,000 susceptible women vaccinated in early pregnancy with 0 CRS cases). Rubella vaccination during pregnancy is NOT an indication for termination. Standalone rubella vaccine is being phased out globally in favor of MR (measles-rubella) or MMR.