Rubella screening and immunization of health care personnel: Critical appraisal of a voluntary program

Primary Prevention and Rubella Immunity: Overlooked Issues in the Outpatient Obstetric Setting

“…Despite the current guidelines of the US Public Health Service's Advisory Committee on Immunization Practices recommending that all healthcare personnel who might have contact with pregnant patients be rubella immune, our data suggest that implementation of these guidelines has been less than effective. 14,15 Our data indicate that female gender, recent medical school graduation (у1980), and providing obstetric or fertility services were independent predictors of knowledge of positive rubella immunity. Given the predominant national strategy of targeting women of childbearing years for rubella vaccination, it is understandable why female gender predicts rubella immunity.…”

Readers:' Forum: Nosocomial Rubella—Consequences of an Outbreak and Efficacy of a Mandatory Immunization Program

“…It has been suggested that there is no evidence that rubella is more likely to have consequences in the health care setting than in the general community and that the cost of immunizing hospital workers is not justified by the number of cases of rubella prevented in pregnant patients. 6 That 14 other hospitals in Los Angeles and others in California reported rubella cases among their staff during this period demonstrates that hospital work-ers are at risk. 15 Prior reports have shown clearly the risk and consequences of transmission to patients attending prenatal care facilities.…”

“…In addition, most outbreaks have reported few occurrences of inter-rupted pregnancy as a consequence of nosocomial rubella and at least one author has raised questions concerning the cost efficacy of employee rubella programs. 6 This report details an outbreak with serious consequences to the employees of a large metropolitan hospital which occurred in the context of a voluntary rubella immunization program. Of importance, no rubella cases occurred in two adjacent hospitals of the same facility which had mandatory immunization policies and who were served by some of the same staff.…”

The Updated Immunization Recommendations for Healthcare Personnel

“…During 1986-1990, serologic surveys in one hospital indicated that 5% of HCP (including persons born in 1957 or earlier) did not have detectable rubella antibody (240). Earlier studies indicated that up to 14%-19% of U.S. hospital personnel, including young women of childbearing age, lacked detectable rubella antibody (225,241,242). In a recent study on rubella seroprevalence among 477 newly hired HCP at a hospital in North Carolina who were born before 1957, and thus considered immune by age, who could not provide written evidence of immunity to rubella, serologic testing revealed that 14 (3.1%) lacked detectable levels of antibody to rubella (157).…”