Successful Elimination of Endemic Rubella in the WHO European Region. Is It Proper to Remove the Recommendation for Preconceptional Immunization?

Author:

Cavaliere Anna Franca1,Parasiliti Marco1ORCID,Franco Rita1,Gallitelli Vitalba1,Perelli Federica2,Spanò Amelia3,Pallone Barbara1,Serafini Maria Grazia4,Signore Fabrizio4,Eleftheriou Georgios5ORCID,Scambia Giovanni3,Lanzone Antonio3,Vidiri Annalisa1ORCID

Affiliation:

1. Department of Gynecology and Obstetrics, Ospedale Isola Tiberina-Gemelli Isola, 00186 Rome, Italy

2. Division of Gynecology and Obstetrics, Santa Maria Annunziata Hospital, USL Toscana Centro, 50012 Florence, Italy

3. Department of Science of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy

4. Department of Gynecology and Obstetrics, Sant’Eugenio Hospital, ASL Roma 2, 00144 Rome, Italy

5. Poison Control Center, Hospital Papa Giovanni XXIII, 24127 Bergamo, Italy

Abstract

Background: Rubella is a contagious viral infection that has garnered significant attention in the field of public health due to its potential consequences, especially during pregnancy. In recent decades, it has been recommended that non-immune women receive immunization during the preconceptional and/or postpartum periods. The goal of this strategy is to prevent primary rubella infection in order to protect pregnant women against congenital rubella syndrome. In November 2022, the WHO’s Regional Verification Commission declared the elimination of rubella infection in Italy. In recent years, the main migration flows to Italy have originated from regions where rubella has not yet been eliminated and where no program is in place to achieve this goal. Objective: The aim of this study was to retrospectively assess rubella immunity in pregnant women who have attended three delivery centers in Rome over the past three years, from January 2021 to May 2023. Methods: Data about the rubella serological status of 7937 non-consecutive pregnant women were collected. Univariate analysis was performed to verify any difference between the study groups in terms of age distribution. Results: Anti-rubella IgG antibodies were found in 7224 (91%) women while 713 (9%) were susceptible to rubella (IgG negative), without differences in terms of immunity rate between Italian and non-Italian women. Age analysis showed a statistically significant older age of immune women than receptive women and of Italian immune women than non-Italian immune women. Conclusions: The National Plan for the Elimination of Measles and Congenital Rubella aimed to achieve a percentage of susceptible women of childbearing age below 5%. These data indicate the relevance of maintaining the recommendation for preconceptional rubella vaccination in Italy.

Publisher

MDPI AG

Reference29 articles.

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3. (2024, February 01). World Health Organization (WHO). Available online: https://www.who.int/publications/i/item/WER8629.

4. (2024, June 01). UpToDate. Available online: www.uptodate.com/contents/rubella-in-pregnancy.

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