Rossolini A, Barberi A
Pediatr Med Chir. 1984 Jan-Feb;6(1):31-4.
The infection caused by the rubella virus is a mild disease usually with no or rare complications in children and adults. On the contrary, intrauterine fetal infection may result in defects of the child, which may either be present at birth or become apparent later in life. Such a risk led to the preparation and use of active immunoprophylaxis against rubella in females of child-bearing age, in order to prevent congenital rubella. Three rubella viruses are employed to prepare the vaccine, all derived from the same viral strain. Doubts however, exist about vaccination, in particular about (1) its teratogenic potential in pregnancy; (2) the duration of protection. As a matter of fact, congenital malformations in the fetus exposed to vaccine virus through the mother have been reported in 3% of cases. As to the second point, the data on the protective immunity in time of the vaccine are very controversial. It is clear, anyhow, that protection against infection is associated not only with persistence of adequate serum levels of antibody, but also with other immunological parameters which are still unknown. These considerations, together with the observation that a relative high percentage of vaccine recipients do not respond, lead us to suggest modifications in the present scheduling of immunization against rubella.
风疹病毒引起的感染是一种轻度疾病,在儿童和成人中通常没有并发症或很少有并发症。相反,宫内胎儿感染可能导致儿童出现缺陷,这些缺陷可能在出生时就存在,也可能在以后的生活中显现出来。这种风险促使人们为育龄女性制备并使用风疹主动免疫预防措施,以预防先天性风疹。制备风疹疫苗使用了三种风疹病毒,它们均源自同一病毒株。然而,对于疫苗接种存在疑问,特别是关于:(1)其在孕期的致畸潜力;(2)保护期。事实上,已有报告称,3%的通过母亲接触疫苗病毒的胎儿出现了先天性畸形。至于第二点,关于疫苗在不同时间的保护性免疫的数据极具争议。无论如何,很明显,预防感染不仅与足够的血清抗体水平持续存在有关,还与其他仍未知的免疫参数有关。这些考虑因素,再加上观察到相对较高比例的疫苗接种者没有反应,促使我们建议对目前的风疹免疫接种计划进行调整。