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Increasing susceptibility to rubella in pregnant women

Increasing numbers of women are being found to lack immunity to rubella during pregnancy, warn Health Protection Agency researchers.

An analysis of samples tested between 2004 and 2009 showed a small but significant year-on-year increase in those whose antibody levels fell below the threshold.

Over the six-year period the number of women found to be susceptible to rubella increased by 60%.

Low antibody levels were particularly common among younger women who would have been eligible for MMR vaccination and in women from ethnic minorities.

Study leader Lisa Bryne, a researcher at NHS Blood and Transplant/HPA Epidemiology Unit, said the number of unprotected women was likely to continue to rise, especially as young women who might have missed out on MMR due to the vaccine scare reached childbearing age: ‘Unless action is taken, this will lead to a substantial increase in demand for post-partum MMR immunisation and potential for raised anxiety among antenatal women.'

The researchers, whose study was published online by Vaccine, recommended opportunistically identifiying rubella susceptibility among ethnic minorities as part of the solution.

Professor Selena Gray, director of the centre for clinical and health services research at the University of the West of England, said. ‘Post partum immunisation schedules are not comprehensively and consistently delivered, and they need to be done in collaboration with primary care.' She said she understood that in Wales GPs were now reimbursed for post partum MMR.

The National Screening Committee is currently reviewing antenatal rubella testing and is due to report in April next year.

Vaccine 2011, published online 23 November

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