The following is the entire vaccination
information sheet packaged with the GlaxoSmithKline Priorix MMR vaccination.
This should be offered to all parents who dutifly turn up at GP surgeries after succoming to reminder letters from the GP or persistent follow ups before they allow their children to be vaccinated. Even one sided arguments in the media may finally wear down one's own natural instinct not to vaccinate.
Panicking mothers may take the helm and steer their little ones to a perceived destination health; the promised land. But remember the Titanic and that foolish espousing of invincibility. Designed by the best engineers not to sink. Of all the scenarios in nature they did not think!
Parents should be allowed to read this information as a first step to informed choice. On no account should any child be vaccinated having been exposed to chickenpox or other herpes type viruses as was ANNA who died ten days after MMR when the measles component was peaking at the same time as her chickenpox. The health visitor was informed by us that Anna had been exposed and that she had a runny nose but she said that it would be OK to vaccinate! I have yet to find any evidence that the MMR has been tested on children with chickenpox. Trials always stipulate that children must be healthy. Children have previously developed Autism that have had a chickenpox vaccine and MMR vaccine combined; inadvertantly discovered on a Merck trial.
If the MMR vaccine was developed under the ethos that all humankind are the same and each person part of the herd, then what we have is nothing short of a lottery. A child's odds of survival free of damage when vaccinated are dependant on a good fit to the controlled circumstance of any trials and to the genetic simalarities to the herd of humans under trial.
In reality the level of toxicity and contamination of vaccines may vary depending on how even the mix of the liquid in the fermenting vats. The dregs at the bottom being more potent a brew.
Exposure to natural virus before vaccination is hard to establish; 21 days incubation for chickenpox.
Trials of vaccines in Denmark, Finland and Sweden are not representative of the diversity of global man's genetic makeup.
PRIORIX Measles, Mumps and Rubella (MMR) vaccine (live)
Information for the Medical, Nursing and Pharmaceutical Professions
1. Name of the Medicinal Product
2. Qualitative and Quantitative Composition
Each 0.5 ml dose of the reconstituted vaccine contains:
- not less than 10 (30) CCID of the Schwarz measles
- not less than 10 (37) CCID of the RIT 4385 mumps, and
- not less than 10 (30) CCID of the Wistar RA 27/3 rubella virus strains.
-CCID - Cell Culture Infective Dose 50
3. Pharmaceutical Form
Lyophilised vaccine for reconstitution with the sterile diluent provided.
4.1. Therapeutic Indications
Priorix is indicated for active immunisation against measles, mumps and rubella.
4.2. Posology and Method of Administration Posology
0.5 ml of the reconstituted vaccine constitutes one dose.
Priorix may be used for both primary immunisation and revaccination of children over 12
months of age, adolescents and adults. The vaccine should be given according to the
Priorix may be given to subjects who have previously been vaccinated with other measles,
mumps and rubella vaccines.
Children who suffered idiopathic thrombocytopenic purpura (ITP) within 6 weeks of the first
dose of MMR (or its component vaccines) should have their serological status evaluated a
the time the second dose is due. If serology testing suggests that a child is not fully
immune against measles, mumps and rubella then a second dose of MMR is
Method of administration
Priorix is for subcutaneous injection.
It may also be given by intramuscular injection. A limited number of subjects received Priorix
intramuscularly in clinical trials in which ah adequate immune response was obtained for all
PRIORIX SHOULD UNDER NO CIRCUMSTANCES BE ADMINISTERED INTRAVASCULARLY. Alcohol and other disinfecting agents must be allowed to evaporate from the skin before injection of the vaccine since they can inactivate the attenuated viruses in the vaccine. •
Priorix is contra-indicated in subjects with known systemic hypersensitivity to any component
of the vaccine or to neomycin (sec also Section 4.4.) A history of contact dermatitis to
neomycin is not a contra-indication.
Priorix must not be administered to pregnant women. Furthermore, pregnancy must be
avoided for one month after vaccination (see Section 4.6).
Priorix should not be given to subjects with impaired immune responses. These include
patients with primary or secondary immunodeficiencies.
However, measles, mumps, rubella-combined vaccines can be given to asymptomatic
HIV-infected persons without adverse consequences to their illness and may be
considered for those who are symptomatic.
As with other vaccines, the administration of Priorix should be postponed in subjects
Suffering from acute severe febrile illness. The presence of a minor infection, however,
is not a contra-indication for vaccination.
4.4. Special Warnings and Special Precautions for Use
As with all injectable vaccines, appropriate medical treatment and supervision should always be readily available in case of a rare anaphylactic event following the administration of the vaccine.
Vaccines produced in chick embryo tissue cultures have been shown not to contain egg proteins in sufficient amounts to elicit hypersensitivity reactions. Persons having egg allergies, that are not anaphylactic in nature, can be considered for vaccination. Priorix should be given with caution to persons with a history or family history of allergic diseases or those with a history or family history of convulsions. Limited protection against measles may be obtained by vaccination up to 72 hours after exposure to natural measles.
Infants below 12 months of age may not respond sufficiently to the measles component of the vaccine, due to the possible persistence of maternal measles antibodies. This should not preclude the use of the vaccine in younger infants (<12 months) since , vaccination may be indicated in some situations such as high-risk areas. In these circumstances revaccination at or after 12 months of age should be considered. Children who suffered idiopathic thrombocytopenic purpura (ITP) within 6 weeks of the first dose of MMR (or its component vaccines) should have their serological status evaluated at the time the second dose is due. If serology testing suggests that a child is not fully immune against measles, mumps and rubella then a second dose of MMR is recommended. Transmission of measles virus from vaccinees to susceptible contacts has never been documented. Pharyngeal excretion of the rubella virus is known to occur about 7 to 28 days :;after vaccination with peak excretion around the 11th day. However there is no evidence of transmission of this excreted vaccine virus to susceptible contacts. Studies have shown that recipients of the Jeryl Lynn strain of mumps virus vaccine do not spread this virus to susceptible contacts and that the virus cannot be isolated from blood, urine or saliva. As with any vaccine, vaccination with Priorix may not result in complete protection of all vaccinees against the infections it is intended to prevent.
4.5. Interaction with other Medicaments and other Forms of Interaction
Although data on the concomitant administration of Priorix and other vaccines are not available, it is generally accepted that measles, mumps and rubella-combined vaccine may be given at the same time as the oral polio vaccine (OPV) or inactivated polio vaccine (IPV), the injectable trivalent diphtheria, tetanus and pertussis vaccines (DTPw/DTPa) and Haemophilus influenzastype b (Hib). Concomitant vaccines should be given by separate injections into different body sites.
If Priorix cannot be given at the same time as other live attenuated vaccines, an interval of at least three weeks should be left between vaccinations. In subjects who have received human gammaglobulins or a blood transfusion, vaccination should be delayed for at least three months because of the likelihood of vaccine failure due to passively acquired mumps, measles and rubella antibodies. However, if Priorix is being given primarily to achieve protection against rubella, the vaccine may be given within three months of the administration of an immunoglobulin preparation or a blood transfusion. In such instances, serological testing should be performed approximately 8-12 weeks later in order to assess the need for re-immunisation.
If tuberculin testing has to be done it should be carried out before, or simultaneously with, vaccination since it has been reported that live measles (and possibly mumps) vaccine may cause a temporary depression of tuberculin skin sensitivity. This anergy may last for four to six weeks and tuberculin testing should not be performed within that period after vaccination to avoid false negative results.
4.6. Pregnancy and Lactation
Priorix is contra-indicated in pregnant women. Furthermore, pregnancy should be avoided
for one month after vaccination.
There are little human data regarding use in breast-feeding women. Persons can be
vaccinated where the benefit outweighs the risk.
4.7. Effects on Ability to Drive and Use Machines
The vaccine is unlikely to produce an effect on the ability to drive and use machines.
4.8. Undesirable Effects
In controlled clinical studies in children aged from 9 months to 2 years, signs and symptoms were actively monitored on more than 5400 vaccinees during a 42-day follow-up period. The vaccinees were also requested to report any clinical events during the study period. The following adverse reactions were considered to have at least a suspected causal relationship with vaccination.
Patient Information Leaflet
PRIORIX (combined Measles, Mumps and Rubella)
Read all of this leaflet before this vaccine is given. Even if the person who is to receive Priorix has been given Priorix or another combined measles, mumps and rubella vaccine before, you should read this text carefully as the information may have changed.
• Keep this leaflet. You may need to read it again.
• If you have further questions, please ask your doctor or pharmacist.
In this leaflet:
1. What is Priorix and what is it used for?
2. Before having Priorix
3. How Priorix is given
4. Possible side effects
5. Storing Priorix
The name of this vaccine is Priorix (combined measles, mumps and rubella vaccine).
The active ingredients in Priorix are one type of live weak measles virus (called Schwarz), one ' type of live weak mumps virus (called RIT 4385, a type of Jeryl Lynn mumps virus) and one type of live weak rubella virus (called Wistar RA 27/3).
Priorix also contains inactive ingredients. These are lactose, sorbitol (E420), the following amino acids; L-alanine, L-arginine, glycine, L-histidine, L-isoleucine, L-leucine, L-lysine HC1, L-methionine, L-phenylalanine, L-proline, L-serine, L-threonine, L-tryptophan, L-tyrosine, L-valine, L-aspartic acid, L-cysteine, L-cystine, L-hydroxproline, and mannitol. Priorix may contain very small amounts of neomycin sulphate.
The Product Licence holder is SmithKline Beecham pic, trading as GlaxoSmithKline UK, Stockley
Park West, Oxbridge, Middlesex, UB11 1 BT.
This vaccine is manufactured by GlaxoSmithKline Biologicals s.a., Rixensart, Belgium.
1. What is Priorix and what is it used for?
Priorix is supplied as a whitish to slightly pink pellet in a single dose glass vial with either a
separate glass ampoule or a prefilled syringe of clear colourless sterile liquid (Water for
Injections) for reconstituting the vaccine.
After mixing with the water, each 0.5 ml dose contains not less than the following amounts of
each virus type: 103 CCID so measles virus (Schwarz strain), 10 •" CCID sa mumps virus (RIT 4385
strain) and 103 CCID w rubella virus (RA 27/3 strain). The term CCID 50 is a way of describing
the number of live viruses present.
When the vaccine is made up it will be light orange to light red in colour.
Priorix is a combined vaccine containing measles, mumps and rubella (German measles) viruses that have been weakened so that they are not able to cause measles, mumps or rubella in healthy people. Also, the types of viruses that are in Priorix cannot be passed from the person who has had the vaccine to other people.
When a person is given the vaccine, the immune system (the body's natural defenses) will
make antibodies against the measles, mumps and rubella viruses. These antibodies protect
against measles, mumps and rubella infections.
As with all vaccines, Priorix may not completely protect all people who are vaccinated against
the infections it is intended to prevent. Also, if the person who is to be vaccinated has already
caught one of these viruses but is not yet ill, Priorix cannot be expected to prevent the illness
Priorix can be given to persons who have been in recent (within three days) contact with a case
of measles and so may be incubating the disease. However, Priorix may not always be able to
prevent measles developing in these cases.
2. Before having Priorix
Priorix is not suitable for everyone. If the answer is YES to any of the following questions, either the vaccine will not be given at all
or the injection will be delayed. These questions may have to be answered by parents/carers for
If you are not sure about anything, ask your doctor or nurse.
Priorix must not be given if the answer is "Yes" to any of the following:
• Has the person who is to receive Priorix ever had a severe allergic reaction to Priorix, or to another combined or single measles, mumps and rubella vaccine, or to neomycin, or to any of the ingredients listed above?
• Does the person who is to receive Priorix have any illness that weakens the immune system?
• Is the person who is to receive Priorix taking any medicine or having any sort of treatment (like radiotherapy) that can weaken the immune system?
• Is the person who is to receive Priorix definitely or even possibly pregnant?
Priorix will, or may be, delayed if the answer to the following is "Yes":
• Does the person who is to receive Priorix have a severe fever (high temperature) or an infection?
• Has the person who is to receive Priorix had a blood or plasma transfusion, or human immunoglobulin within the last three months? If so, the antibody response to Priorix may be low so it is usual to wait for three months before giving Priorix. Priorix can be given at the same time as or within three months of a blood or plasma transfusion or human immunoglobulin if it is being given mainly to protect against rubella. If this is the case, a blood test will usually be taken about 2-3 months later to make sure that the immune system has made a good response to the vaccine.
• Is the person due to have a skin test for possible tuberculosis? If this test is done within 4 to 6 weeks after receiving Priorix, the result may not be reliable.
• Is the person who is to receive Priorix under 12 months old? Children under 12 months may not make a good immune response to the measles virus so Priorix is not usually given until after the first birthday. See section 3 for more information.
Take special care with Priorix
If the answer is "Yes" to any of the following questions, talk to your doctor or nurse before the vaccine is given. Your doctor or nurse will advise you if Priorix can be given. Has the person who is to receive Priorix:
• Ever had a severe allergic reaction to eggs or anything that contained egg?
• Got a history or family history of allergies or of convulsions (fits)?
• Had a side effect within about 6 weeks after a single or combined measles, mumps and rubella vaccine (whether or not this was Priorix) that involved easy bruising or bleeding for longer than usual?
Priorix must not be given to pregnant women.
Also, women should avoid getting pregnant for one month after having the vaccine. Talk to
your doctor or nurse if you need advice on reliable birth control.
Women who are breastfeeding may sometimes be vaccinated. Talk to your doctor or nurse If you are breastfeeding.
Driving and using machines
It is unlikely that Priorix would affect driving or operating.machinery skills.
Taking other medicines and having other vaccines
Priorix must not be given to persons who are taking medicines that can weaken the immune system.
Priorix may be given with other routine childhood vaccines that may be due to be given at the same time. If any other vaccines (for example, vaccines that are given before going abroad) are to be given at the same time as, or very near in time to Priorix, talk to your doctor or nurse before Priorix is given. Make sure that your doctor or nurse is told about all medicines that are being taken by the person who is to receive Priorix and about all vaccines that may have been given a few weeks before or are due to be given within a few weeks after Priorix.
3. How Priorix is given
It is currently recommended that the first dose of a combined measles, mumps and rubella vaccine such as Priorix should be given at about 12 to 15 months of age. It is recommended that a second dose of a combined measles, mumps and rubella vaccine, such as Priorix, should be given before a child starts school. It does not matter if the first injection was with Priorix or with other measles, mumps and rubella vaccines.
requencies are reported as:
Very common: > or = 10%
Common: > or = 1% and < 10%
Uncommon: > or = 0.1% and < 1 %
Rare: > or = 0.01% and < 0.1%
Very rare: < 0.01 %
common: local redness, pain and swelling Body as a whole:
common: fever > 38.5°C when measured orally or by the axillary route Central and peripheral nervous system:
uncommon: febrile convulsions very rare: peripheral neuritis
uncommon: parotid swelling Gastro-intestinal system:
uncommon: diarrhoea, vomiting Psychiatric:
uncommon: nervousness Resistance mechanism:
uncommon: viral infection, otitis media Respiratory system:
uncommon: pharyngitis, upper respiratory tract infection, rhinitis, bronchitis, coughing Skin and appendages:
White cell and reticuloendothelial system:
During post-marketing surveillance, the following reactions have been reported in temporal association with Priorix vaccination: Body as a whole:
very rare: allergic reactions (including anaphylactic reactions) Central and peripheral nervous system:
very rare: meningitis Platelet, bleeding and clotting:
very rare: thrombocytopenia, thrombocytopenic purpura Skin and appendages:
very rare: erythema multiforme
As in natural rubella infection, arthralgia or, in isolated cases, chronic arthritis as well as
myalgia, exanthema and swollen lymph nodes may occur two to four weeks after
administration of live rubella vaccines. The incidence of joint reactions increases with the
age of the vaccinee. Cases of exudative arthritis are extremely rare.
In comparative studies with other measles, mumps and rubella vaccines, the incidences of
local pain, redness and swelling reported with Priorix were low, while the incidences of
other adverse reactions were similar.
5.1. Pharmacodynamic Properties
The safety and immunogenicity of Priorix in adolescents and adults has not been specifically studied in clinical trials.
In clinical studies in children aged from 12 months to 2 years Priorix has been demonstrated to be highly immunogenic. Following primary vaccination with a single dose of Priorix in the second year of life antibodies against measles were detected in 98.0%, against mumps in 96.1 % and against rubella in 99.3% of previously seronegative vaccinees. One hundred and fifty five children aged 10-22 months at immunisation were followed up for 12 months post vaccination. All remained seropositive for anti-measles and anti-rubella antibodies. 88.4% were still seropositive at month 12 for anti-mumps antibody. This percentage is in line with what was observed for other measles, mumps and rubella-combined vaccines (87%).
5.2. Pharmacokinetic Properties
5.3. Preclinical Safety Data
6.1. List of Excipients
Vaccine: The vaccine contains the following amino acids:
L-alanine, L-arginine, glycine, L-histidine, L-isoleucine, L-leucine, L-lysine HC1,
L-methionine, L-phenylalanine, L-proline, L-serine, L-threonine, L-tryptophan, L-tyrosine,
L-valine, L-aspartic acid, L-cysteine, L-cystine, L-hydroxproline, and lactose, mannitol,
The vaccine may also contain residual amounts of neomycin 25 micrograms maximum.
Diluent: Water for Injections
Priorix should not be mixed with other vaccines in the same syringe.
The shelf-life of Priorix is two years when the vaccine is stored according to recommendations (see Section 6.4.) The shelf lives of the vaccine and diluent are not identical, therefore their expiry dates are different. The outer carton bears the earlier of the two expiry dates and this date must be respected. The carton and ALL its contents should be discarded on reaching the outer carton expiry date.
6.4. Special Precautions for Storage
Priorix should be stored in a refrigerator between 2°C and 8°C and protected from light. Do not freeze.
During transport, recommended conditions of storage should be respected, particularly in hot climates.
6.5. Nature and Contents of Container
Priorix is presented as a whitish to slightly pink pellet in a glass vial. The sterile diluent is clear and colourless and presented in a glass prefilled syringe or ampoule. Due to minor variation of its pH, the reconstituted vaccine may vary in colour from light orange to light red without deterioration of the vaccine's potency.
Vials, prefilled syringes and ampoules are made of neutral glass type I, which conforms to European Pharmacopoeia requirements.
6.6. Instructions for Use/Handling
The diluent and reconstituted vaccine should be inspected visually for any foreign paniculate matter and/or variation of physical aspects prior to administration. In the event of either being observed, discard the diluent or reconstituted vaccine.
The vaccine must be reconstituted by adding the entire contents of the supplied container of diluent to the vial containing the pellet. After the addition of the diluent to the pellet, the mixture should be well shaken until the pellet is completely dissolved in the diluent. Inject the entire contents of the vial.
It is normal practice to administer the vaccine immediately after reconstitution with the diluent provided. However, the vaccine may still be used up to 3 hours after reconstitution or to the end of the vaccination session whichever is sooner.
7. Marketing Authorisation Holder
SmithKline Beecham pic
Great West Road, Brentford, Middlesex TW8 90S
GlaxoSmithKline UK Stockley Park West Uxbridge Middlesex UB11 1BT
8. Marketing Authorisation Number
9. Date of First Authorisation/Renewal of Authorisation
4 December 1997
10. Date of (Partial) Revision of the Text
3 September 2004
11. Legal Category
Children who have missed their appointment to have the first dose should attend as soon as possible to be vaccinated. Your doctor or nurse will advise when the second dose should be given.
Children who have missed their appointment to have the second dose should attend as soon as possible to be vaccinated in order to keep protected against these infections.
Sometimes measles, mumps and rubella vaccines are given to infants who are less than 12 months old because they are thought to be at high risk of infection with one of these diseases. When this happens, another dose is recommended when a child is 12-15 months old. Your doctor will discuss this with you.
Teenagers and Adults
Priorix can also be given to teenagers and adults if it is thought or known that they are not protected against one or more of measles, mumps or rubella. Your doctor or nurse will advise'' you if you need to be vaccinated against these infections.
Priorix is usually injected under the skin (occasionally into the muscle) and usually in the upper arm. Your doctor or nurse may wipe the skin with alcohol or other disinfecting agents and will let the skin dry before the injection. Your doctor or nurse will take care that Priorix is not injected into the bloodstream.
Because the vaccine is supplied in single dose vials, and because it is then made up and injected by a doctor or nurse, it is very unlikely that you/your child could be given too much.
4. Possible side effects
Like all medicines, including all vaccines, Priorix can have side effects.
Severe allergic reactions can occur very rarely (in less than one in ten thousand persons) and usually happen very soon after the injection. These can involve difficulty breathing, tightness in the throat, rapidly spreading rashes, dizziness, loss of consciousness because of very low blood pressure, and a very fast heart beat. These severe reactions need urgent medical help. Therefore, the person who has received Priorix may be asked to stay in the surgery or vaccination area for a short time after the vaccine has been given to check that an immediate allergic reaction does not occur. If the person who has had Priorix develops any of these or,any other worrying effects after leaving the clinic, it is urgent to get medical help.
Tell your doctor immediately if you experience any of the following:
• Purple skin spots, unexplained bruises or prolonged bleeding from cuts (this is caused by a
drop in the number of platelets, blood particles which help stop bleeding)
• A widespread skin rash that have blistering
• A severe headache with a stiff neck.
These events are also very rare (less than one in ten thousand persons),
Uncommonly, (in less than one in a hundred but more than one in a thousand) children who get a fever after having Priorix may also have fits (convulsions). If your child gets a temperature after having Priorix, the following may help to reduce your child's fever and prevent fits.
• Remove your child's clothing
• Sponge your child with tepid water
• Give paracetamol (as recommended by your doctor or the vaccination nurse)
If your child does have a fit, tell your doctor immediately, or take the child to an accident and
The commonest other side effects (in more than one in a hundred but less than one in ten persons) after having Priorix are reactions at the site of the injection. These include local redness, local pain and swelling. Rash and fever may also occur commonly.
Other uncommon side effects (in less than one in a hundred but more than one in a thousand persons) include: swollen glands in the cheek, swollen glands elsewhere in the body, nervousness, sore throat, runny nose, coughing, vomiting, diarrhoea, chest infections, ear infections and other viral infections.
Very rarely (in less than one in ten thousand persons) there can be inflammation of some nerves, possibly with pins and needles or loss of feeling or normal movement.
Vaccination against rubella (German measles) can sometimes be followed by symptoms that can occur during natural infections with the virus. These include joint and muscle pains (very rarely the joint problems can persist), rashes and swollen glands from about 2 weeks until about 4 weeks after vaccination. Older persons are more likely to have joint pains than young children.
If any side effects continue or become severe, tell the doctor or nurse. If you notice any side effects not mentioned in this leaflet please tell your doctor or nurse.
5. Storing Priorix
Your doctor or nurse will usually have supplies of Priorix and will have stored it correctly.
However, if you have been given a prescription to get the vaccine and have been asked to
store it until the injection is given, you should store Priorix in a refrigerator between 2°C and
8°C and protect it from light until it is given. The vaccine should not be frozen. The doctor or
nurse should check that the expiry date on the outer package label has not passed.
Keep this vaccine out of the sight and reach of children.
Once the vaccine has been mixed with the water supplied it should be used within three hours.
Leaflet last revised in: September 2004
Priorix is a registered trademark of the GlaxoSmithKline group of companies © 2004 GlaxoSmithKline group of companies
Disease information on measles, mumps and rubella
Measles - Measles is an infectious illness caused by a virus. It is passed on by breathing in droplets in the air from infected people. The main signs of the illness include a rash, runny nose and a fever. Some people (particularly underfed or ill children) can get other symptoms that include ear infections, chest infections such as bronchitis and pneumonia, and fits. Measles can be fatal. Deaths from measles have fallen since the introduction of a measles vaccine in 1968. It is important that individuals and particularly children are immunised against measles to reduce the number of complications and deaths from this illness.
Mumps - Mumps is an infectious illness also caused by a virus. It is passed on by breathing in droplets in the air from infected people. The main sign of the illness is swelling of the glands that produce saliva that are found in the cheeks and near the ears. The swelling can be on one or both sides of the face in the cheek area. Some people also have inflammation of the pancreas, inflammation of the ovaries or testicles that sometimes cause fertility problems in later life, meningitis, and deafness that continues after recovering from the illness itself.
Rubella - Rubella is an infectious illness also caused by a virus. The main signs of rubella are a rash and swollen glands. If pregnant women get rubella infection in the first 12 weeks of pregnancy it can cause damage to the unborn child in about nine out of 10 cases. This damage can include mental handicap, blindness, deafness and heart problems. Before widespread vaccination of both boys and girls, rubella used to be particularly common in children aged four to nine years. Also, when rubella vaccine was only given to girls at puberty or to older women before they became pregnant (which used to be the recommendation until 1988), there were still many cases of infection in pregnant women. This was because not all of them had been vaccinated before becoming pregnant and they caught the infection from younger children of both sexes. Therefore, vaccination of both boys and girls while they are still under five years old, with a first dose in the second year of life, is very important to protect against rubella in children and to prevent infections in pregnant women. Any teenagers or adults who are not protected against rubella should also be vaccinated. For women, vaccination should be done before the first pregnancy or between pregnancies. For teenagers or adult women and men, vaccination protects them against rubella and also reduces the risk that they might pass on the infection to a pregnant woman.