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RUBELLA

Find most of the information you need in these resources

Always refer to your local signed PGD's in practice, and remember the Green Book takes priority over the SPmC - and sometimes WHO takes priority over the Green Book! They don't always say the same!

Recent Updates & News

17th Dec: The MMRV programme: information for healthcare practitioners has been updated ready for Jan. Also, a common query clarified, ‘What counts as a valid second dose of MMR-containing vaccine?’ Another one to check out and bookmark.

10th Dec: Childhood schedule changes 2025 and 2026: information for healthcare practitioners doc updated to account for MMRV. This is a VERY useful doc. Get it bookmarked ASAP!. This doc has also been produced: MMRV and febrile convulsions. Febrile convulsions are a common in children with a high fever, this guidance explains to parents and carers what a febrile convulsion is, and when to seek medical help.

8th Dec: New MMRV poster for the public. And, if you signed up for the webinar last week about MMRV the resources have been emailed out now. The slides and webinar recording link are here.

28th Nov: MMRV information for healthcare practitioners is here!

26th November: The latest Vaccine Update newsletter has landed. It's an informative read with some bite-sized summaries around the new MMRV programme (also the PGD's are out for that prog too MMR and MMRV).

6th Nov: Check out the new (very informative) slideset about the MMRV programme.

31st October 2025! VERY IMPORTANT DOCUMENTS relating to MMRV programme. AND here's the LETTER

On Wednesday 3 December 2025, 14:00 – 15:15, the UK Health Security Agency (UKHSA) Immunisation Team will be hosting a webinar about the second phase of the planned changes to the routine childhood vaccination schedule which will be implemented from January 2026. This will include the introduction of a varicella (chickenpox) vaccination programme (MMRV) and a new routine vaccination appointment at 18 months of age. Health Professionals only. Sign up here.

30th April: A BIG update came along today - the 'changes to the routine childhood schedule letter'. Big read with lots of changes to absorb. I won't repeat it all here but do have a good read.... some of this relates to MMR scheduling on the childhood prog. (see UKHSA webinar link on news page in June and consider registering for more info). Expect Green Book updates, PGD changes and perhaps a small amount of chaos while we adapt to the changes. Keep calm and keep the kettle on....

The Green Book chapter was last updated in 2013!

So, like with Mumps, let's have a quick recap on the history of Rubella vaccination with the help of the Green book.

Rubella immunisation was introduced in the UK in 1970 for pre-pubertal girls and non-immune women of childbearing age to prevent rubella infection in pregnancy. Rather than interrupting the circulation of rubella, the aim of this strategy was to directly protect women of childbearing age by increasing the proportion with antibody to rubella; this increased from 85 to 90% before 1970 to 97 to 98% by 1987.

Surveillance for congenital rubella was established in 1971 to monitor the impact of the vaccination programme. During the period 1971–75 there were an average of 48 CRS births and 742 terminations annually in the UK.

Universal immunisation against rubella, using the measles, mumps and rubella (MMR) vaccine, was introduced in October 1988. The aim of this policy was to interrupt circulation of rubella among young children, thereby protecting susceptible adult women from exposure. At the same time, rubella was made a notifiable disease. A considerable decline in rubella in young children followed the introduction of MMR, with a concomitant fall in rubella infections in pregnant women – from 167 in 1987 to one in 2003.

THEN SUCCESS!! In 2015 the WHO announced that the UK had eliminated rubella. There are now very few cases of rubella each year in the UK - not enough for the disease to circulate widely in the population. Rubella vaccination in the UK has prevented roughly around 1.4 million cases of rubella, 1,300 cases of CRS-related birth defects, and averted 25,000 terminations. YAY!!!

MMR Vaccine & Autism claims:

Some findings from the literature

Here are some simple reassuring study findings taken from the Green Book if this becomes a topic of discussion in a consultation:

No increased risk of autism in children vaccinated with MMR compared with unvaccinated children (Farrington et al., 2001; Madsen and Vestergaard, 2004)
No clustering of the onset of symptoms of autism in the period following MMR vaccination (Taylor et al., 1999; De Wilde et al., 2001; Makela et al., 2002)
The increase in the reported incidence of autism preceded the use of MMR in the UK (Taylor et al., 1999)
The incidence of autism continued to rise after 1993, despite the withdrawal of MMR in Japan (Honda et al., 2005)
There is no correlation between the rate of autism and MMR vaccine coverage in either the UK or the USA (Kaye et al., 2001; Dales et al., 2001)
No difference between the proportion of children developing autism after MMR who have a regressive form compared with those who develop autism without vaccination (Fombonne, 2001; Taylor et al., 2002; Gillberg and Heijbel, 1998)
No difference between the proportion of children developing autism after MMR who have associated bowel symptoms compared with those who develop autism without vaccination (Fombonne, 1998; Fombonne, 2001; Taylor et al., 2002)
No vaccine virus can be detected in children with autism using the most sensitive methods available (Afzal et al., 2006).

The fake MMR claims that struck fear into generations of parents: Metro article

Have a google of Andrew Wakefield. This discredited doctor is one of the reasons we still see a lot of anxiety around MMR vaccines

MMR for all: general leaflet

This leaflet explains the measles mumps rubella (MMR) vaccine for all ages. and another one arrived Nov 2025 for those eligible for MMRV.

Bits and bobs to casually drop into conversation

Did you know....

According to the Green Book:

Maternal rubella infection in pregnancy may result in fetal loss or in congenital rubella syndrome (CRS). CRS presents with one or more of the following:

cataracts and other eye defects
deafness
cardiac abnormalities
microcephaly
retardation of intra-uterine growth
inflammatory lesions of brain, liver, lungs and bone marrow.

Infection in the first eight to ten weeks of pregnancy results in damage in up to 90% of surviving infants; multiple defects are common. The risk of damage declines to about 10 to 20% with infection occurring between 11 and 16 weeks gestation. Fetal damage is rare with infection after 16 weeks of pregnancy, with only deafness being reported following infections up to 20 weeks of pregnancy. Some infected infants may appear fine at birth but perceptive deafness may be detected later.

Before the introduction of rubella immunisation, rubella occurred commonly in children, and more than 80% of adults had evidence of previous rubella infection

Above: Baby with Congenital Rubella Syndrome. Below: Characteristic macropapular rash indicative of Rubella.

Images courtesy of the CDC and found on the hyperlink on the pictures - visit that link to see more images of Rubella - if you dare!