Does the rubella vaccine protect the unborn child from Congenital Rubella Syndrome (CRS)?

More importantly however is the impact of rubella vaccine on congenital rubella syndrome (CRS), symptoms in the developing embryo that could lead to birth defects or death of the foetus. What exactly are the symptoms of CRS?

As with many illnesses there are two stages to consider; the immediateacute symptoms and if not resolved, the long-tem chronic condition. Steven Parker, MD at Boston University School of Medicine in his guide for parents and health professionals notes the conditions associated with what he terms early and delayed phases of CRS, observing that they also range from very mild to very severe:

Babies born with CRS are very different from each other. Some have significant disabilities, while others are barely affected. In fact, children with CRS are more likely to be different from each other than they are to be similar. That’s why it is difficult to present a typical picture of CRS. There is no typical picture.”

This of course makes it difficult if not impossible to assess the impact of a vaccine on a syndrome that varies widely in symptoms and in which the reporting of CRS has had no possibility of standardisation before and after the introduction of the vaccine. Unless a doctor decides to carry out their standard tests for rubella, it is highly likely that many individuals with these symptoms will not be diagnosed as having CRS.

According to Steven Parker, MD the acute early problems of CRS can be one or several of the following:

  • Hearing loss of any degree.
  • Vision problems ranging from normal to total blindness, problems include: Cataract (one or both eyes); inflammation of the retina (retinopathy); eye movement problems (nystagmus); and small eyes (microphthalmia); optic atrophy, corneal haze and glaucoma.
  • Heart problems which include: Patent ductus arteriosus; pulmonary artery stenosis, pulmonic valve stenosis; and ventricular septal defect.
  • Neurological problems or brain damage may or may not exist, may range from mild to very sever, problems can include: Small head (microcephaly); large soft spot of head (bulging fontanelle); lethargy; irritability; learning disabilities; mental retardation (mild, moderate, severe or profound); movement problems (cerebral palsy, spastic diplegia, hypotonia); poor balance and posture; lack of coordination; and seizure disorders.
  • Growth problems: Small size (intrauterine growth retardation).
  • Genitourinary Problems: Undescended testicles (cryptorchidism); hernia (inguinal hernia); hypospadias.
  • Other (Less Common) Problems: Swollen glands (adenopathy); liver inflammation (hepatitis); low blood count (hemolytic anemia); low platelet count (thrombocytopenic purpura); pneumonia (interstitial pneumonitis); bone lesions (metaphyseal striations); abnormal palm creases.

The delayed-onset manifestations of CRS in the main, affect the hormonal system and the brain, they include:

Insulin Dependent Diabetes MellitusOveractive thyroid gland (hyperthyroidism) or an underactive thyroid gland (hypothyroidism).

  • Glaucoma: While glaucoma is infrequent in infants with acute CRS, it may show up at a later time, especially if cataract surgery has been performed. While most ocular findings are present at birth, there are cases of eye problems emerging later in life (e.g. detached retinas), especially if head banging or eye poking is present.
  • Change in Hearing Ability: Both hearing loss and hearing gains have been recorded after the first few years of life.
  • Neurological System and Behaviour CRS may be characterized by poorly understood changes in the neurological system. New onset or changes in seizure disorder, changes in tone, posture, coordination and strength. Changes in behaviour or new behaviours occasionally develop over time including attention deficit disorder, impulsivity; self-injurious behaviours and autistic behaviours.

The impact of Rubella vaccine is therefore difficult enough to assess, but the assessment of the vaccine takes on a further twist when we consider that the evidence for the effectiveness of the vaccine is taken from the overall impression that we have fewer cases of birth defects since the use of the vaccine.

However routine abortion is offered to women that are suspected to have contracted rubella during pregnancy…

…which is of course a major factor influencing the numbers of birth defects presenting, add to that the various policies around the world of advising termination of pregnancies in foetuses with heart defects and other problems, we are of course eliminating the problems before they are born and have no way of assessing the impact of vaccines or any interventions in reducing birth defects by simply looking at the number of children born with these defects. They are bound to be lower since the introduction of routine abortion policies.

But the problems don’t stop there, a cursory glance at our list of long term CRS symptoms may miss the fact that they also include:

… attention deficit disorder, impulsivity; self-injurious behaviours and autistic behaviours.”

Are we to assume in this present climate that we have reduced the incidence of attention deficit disorders and autism? By extolling the virtues of rubella vaccine in reducing congenital disorders, how many people are aware that autism is part of the rubella syndrome that should of course be reducing as a result of vaccination, the main vaccine being MMR?