Study Examines Rubella Persistence Post-Vaccine in Immunodeficient Patients

Patients with severe immunodeficiency may be predisposed to adverse effects from the vaccine
Patients with severe immunodeficiency may be predisposed to adverse effects from the vaccine

Some patients with primary immunodeficiency disorders may be at risk for rubella virus infection and possible serious skin inflammation after receiving the rubella vaccine, a study published in the Journal of Allergy and Clinical Immunology has found. 

The rubella vaccine, usually given as part of the measles-mumps-rubella (MMR) vaccine, has demonstrated safety and efficacy in the general population. However, patients with severe immunodeficiency may be predisposed to adverse effects from the vaccine. The prescribing information states that the vaccine should not be administered to immunodeficient patients. "Our new study found genuine evidence of harm in a subset of patients with these rare disorders," explained lead author Kathleen E. Sullivan, MD, PhD, from The Children's Hospital of Philadelphia (CHOP).  

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Earlier case reports had shown incidence of vaccine-related granulomas in patients with  primary immunodeficiency diseases (PIDD). For this study, Dr. Sullivan and team analyzed data of 4 adults and 11 children with different PIDDs who had cutaneous granulomas. Three of the children died from severe infection and 7 of the total patients exhibited rubella virus antigen in their granulomas. 

The findings suggest that since PIDDs compromise the patient's immune system, the patients are unable to remove the weakened rubella virus found in the vaccine. The virus then lingers in their bodies causing damage to skin cells and possibly leading to ulcers. 

Dr. Sullivan added that the research further confirms the warning stated in the rubella vaccine package inserts. "It gives additional guidance to physicians and families as to who should be restricted from the MMR vaccine."

For more information visit jacionline.org.

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