What are the complications of contracting Rubella as a pregnant individual?
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The risk of profound birth defects (i.e., cataracts, congenital heart disease, deafness)
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The risk of pregnancy-related complications
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The risk of neonatal death
What are the risks of contracting Rubella as a pregnant individual with IBD?
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The risk of infection is low
Should I receive the Rubella vaccine during pregnancy as an individual with IBD?
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To receive the MMR booster, all immunosuppressive agents have to be stopped 3 months before receiving the vaccine and only restarted 3 weeks after receiving the vaccine
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There is a risk of disease relapse which can negatively impact the pregnancy
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Additionally, there is a theoretical risk that the weakened strain of pathogen in the vaccine can cross the placenta and cause harm to the fetus
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Given the low risk of Rubella infection in the community, Gastroenterologists generally do not favor stopping immunosuppressive agents and hence the administration of the Rubella vaccine
I feel strongly about getting the Rubella vaccine. What can I do?
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An Infectious Diseases specialist should be consulted for a formal opinion on the risks and benefits of receiving the vaccine and stopping immunosuppressive agents for the required time period.
Reference for additional reading:
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Benchimol EI, Tse F, Carroll MW, deBruyn JC, McNeil SA, Pham-Huy A et. al. Canadian Association of Gastroenterology Clinical Practice Guideline for Immunizations in Patients With Inflammatory Bowel Disease (IBD) - Part 1: Live vaccines. JCAG. 2021 Jul;4(4):e59-71. DOI: 10.1093/jcag/gwab015