Not rubella immune

[RND25]

I am an adult ICU RN, 11 wks pregnant, and recently learned that I am no longer immune to rubella. I think my level was 4, & it should be greater than 9. I did have 2 MMR vaccinations as a child, and two years ago did test rubella immune. The good thing is, I work for a nursing agency and do not HAVE to work, but if I choose to not work anymore throughout my pregnancy, plus a maternity leave, I will be out of the workplace for close to a year. I have already decided I won't work again until I am 20 wks along, when the greatest danger of rubella to my baby would exist. For now, I am trying to avoid crowds, and children that I may not be sure are vaccinated, in general. One doctor I spoke with said that if exposed, I would still likely mount an immune response, even though my titer is showing non-immune. I am super confused, and obviously very anxious about this- we live in an area that has a high percentage of people who choose not to vaccinate. My question is, does anyone have experience working in the inpatient setting while pregnant and non-immune to rubella? I should also note that as an agency RN, I do not really get to be picky about my patient assignment.

[klone, MSN, RN]

We see pregnant women all the time who are rubella non-immune. It's not a big deal and not a medical emergency. We just flag the chart so she receives the MMR postpartum. This is where herd immunity is a really awesome thing.

ETA: I believe the CDC and WHO considers rubella eradicated in the US as of 2014.

[JustMeRN]

I am an adult ICU RN, 11 wks pregnant, and recently learned that I am no longer immune to rubella. I think my level was 4, & it should be greater than 9. I did have 2 MMR vaccinations as a child, and two years ago did test rubella immune. The good thing is, I work for a nursing agency and do not HAVE to work, but if I choose to not work anymore throughout my pregnancy, plus a maternity leave, I will be out of the workplace for close to a year. I have already decided I won't work again until I am 20 wks along, when the greatest danger of rubella to my baby would exist. For now, I am trying to avoid crowds, and children that I may not be sure are vaccinated, in general. One doctor I spoke with said that if exposed, I would still likely mount an immune response, even though my titer is showing non-immune. I am super confused, and obviously very anxious about this- we live in an area that has a high percentage of people who choose not to vaccinate. My question is, does anyone have experience working in the inpatient setting while pregnant and non-immune to rubella? I should also note that as an agency RN, I do not really get to be picky about my patient assignment.

If you live in a low immunization area you are likely more at risk from areas where large groups of people (especially children and international travelers) congregate. Disneyland and the whole measles outbreak being a prime example of a place you should probably avoid for now. Can your agency assign you an LTC stint for a bit? Not a lot of travelers or visitors (sadly) in LTC. I would try not to freak out too much, don't lock yourself away in fear. Just be cautious. You can usually find info about outbreaks on the cdc and local health department web pages if it makes you feel better knowing where outbreaks are occurring.