Rubella Immune Status among Infertile Women: A Priority Vaccination Cohort

Abstract

Ab s t r Ac t Aim and objective: Congenital rubella syndrome (CRS), a consequence of rubella virus infection in the first trimester of pregnancy is a silent crippling disease endemic in India. This study sought to find out and vaccinate rubella susceptible women attending a fertility clinic in an urban setup. Materials and methods: As an institutional policy, all females attending fertility clinic were screened for anti-rubella IgG antibodies. A total 2272 non-duplicate serum samples received between January 2011 and December 2017 were processed using enzyme-linked fluorescent assay using mini VIDAS system following standard recommendations. Any value <10 IU/mL was regarded negative, between 10 and 15 as equivocal and >15 as positive. Results: An average of 10.95% women was susceptible to rubella whereas 86.75% were immune to it. Samples from 52 women gave equivocal results and they were considered to be susceptible. All susceptible females were vaccinated with R-vac and treated for infertility one month after vaccination. Age-specific immune status was not significant. A trend analysis revealed steady increase in immunity from 2011 to 2017 with a slight drop in 2016. Conclusion: The proportion of susceptible females of reproductive age who need to be vaccinated is significant. This study emphasizes the need for preconception screening as we would have an opportunity to vaccinate susceptible women. Clinical significance: There is a need for preconception screening of rubella not only in infertile women but also normal reproductive age females. With successful eradication of polio, elimination of rubella and measles being the next targets, combined vaccination strategy is the key to rubella elimination.