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| |  No Link Found Between Rubella Vaccination And Chronic Arthritis CHICAGO -- August 19, 1997 -- Women who receive a vaccine against rubella do not appear to be at increased risk of chronic arthritis or other joint diseases as previous studies have suggested, according to an article in the August 20 issue of The Journal of the American Medical Association (JAMA). Paula Ray, M.P.H., from the Northern California Kaiser Permanente Vaccine Study Center in Oakland, and colleagues studied medical records of women aged 15 to 59 who were tested for rubella antibodies in 1990 and early 1991. The women were divided into three groups: 971 tested negative and were given the RA 27/3 rubella vaccine; 924 tested negative and were not vaccinated; and 2,421 tested positive for rubella antibodies and were not vaccinated. During a one-year follow-up period, the researchers looked for prevalence and incidence of arthritis and other joint disease, neurologic conditions, numbness or tingling of the skin, lupus (a chronic disease that causes inflammation of connective tissue), chronic fatigue syndrome, fibromyalgia (a form of soft-tissue or muscular rheumatism), carpal tunnel syndrome (numbness, tingling and pain in the thumb, index and middle fingers), and tendinitis (inflammation of a tendon). They found no evidence of any increased risk of chronic joint disease or neurologic conditions among the women vaccinated against rubella. "Prevalence did not differ significantly across the three groups with the exception of vaccinated women at least 30 years old who were approximately twice as likely to have been diagnosed with carpal tunnel syndrome as those in either of the comparison groups," the authors write. Rubella is also known as "German measles." It is usually a mild disease among children, but it can be serious if it affects a woman in the early months of pregnancy. If the rubella virus infects the fetus, it can lead to severe birth defects. Previous studies have suggested a relationship between rubella vaccination and chronic arthritis among women. But these new findings do not support withholding rubella vaccine because of concerns of inducing chronic joint disease, according to Carin M. Olson, M.D., JAMA contributing editor. The researchers also found that a woman's age appears to play a role in increased risk of joint disease: "... age is a risk factor for most of the outcomes studied regardless of serological or immunization status." "Public health programs promoting rubella vaccination, including for women at risk, have had an important role in reducing the individual and societal impact of congenital rubella syndrome,” they conclude. “Our findings support the continued vaccination of rubella-susceptible women of childbearing age as a safe and effective means of preventing congenital rubella syndrome." Editorial: Study Should Ease Side Effect Fears In an accompanying editorial, Paul E. Slater, M.D., M.P.H., of the Department of Epidemiology of the Israel Ministry of Health in Jerusalem, applauds the study by Ray and colleagues as one of the strongest yet to address the question of whether rubella vaccination might lead to significant chronic joint disease. Citing two other studies as well, he concludes: "Taken together, these well-designed and well-executed studies should put an end to the fear of major permanent joint disability resulting from administration of rubella vaccine to women. Until circulation of rubella virus is eliminated from Western countries ... seronegative women of childbearing age should be sought and offered rubella vaccine so that the risk of congenital rubella can be lowered to an absolute minimum." The study by Ray and colleagues was funded by the Centers for Disease Control and Prevention Vaccine Safety Datalink Project. (JAMA. 1997;228:551-556)
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