Evaluation of Rubella Immunity in a Community Prenatal Clinic

Since the introduction of the Rubella vaccine in 1969, prevalence of congenital Rubella syndrome (CRS) has greatly declined in the United States. However, reports of sporadic adult cases of the disease and frequent identification of non-Rubella immune (NRI) women in prenatal units may result in outbreak of CRS in susceptible communities. Identifying populations with high rates of NRI will assist in evidence-based public health intervention that may prevent epidemic of CRS in the United States. Method. This is a retrospective, cross-sectional study involving chart audit of Rubella screening results of 642 women who attended a high-risk prenatal care at a northwestern Iowa clinic between January 1 and December 31, 2007. Results. NRI was found in 6.9% of the study population. The highest prevalence rate of 10.2% was found among adolescents. NRI was highest among Native American women at 17.3%, compared to Whites 7.3%, African Americans 5.9%, and Hispanics 4.6%. Multivariate analysis demonstrated that Native Americans were 2.5 times more likely to be NRI compared to Whites (OR 2.7; 95% CI: 1.1, 6.6). Conclusion. This study demonstrated higher rate of non-Rubella immunity among adolescent pregnant women and supports Rubella booster immunization for all non-pregnant teenage women. The observed high rate of NRI among Native Americans may require further studies and evaluation of Rubella vaccination programs in tribal communities.