Low postpartum rubella vaccination rates in high-risk women, Miami, Florida, 2001

Am J Prev Med. 2006 Feb;30(2):119-24. doi: 10.1016/j.amepre.2005.10.013.


Objective: To evaluate adherence to the Advisory Committee on Immunization Practices' recommendations on postpartum rubella vaccination in hospitals with a high proportion of foreign-born Latina mothers, the highest risk group for congenital rubella syndrome.

Methods: In four large hospitals in Miami-Dade County, maternal medical records for births in 2001 were randomly selected. Using demographic information from birth certificates, vaccination information from medical records, and policy information from a hospital survey, postpartum rubella vaccination rates were characterized among women eligible for vaccination (non-immune and not screened) through univariate and multivariable analyses. Data collection was performed in 2002-2003 and the analysis was completed in 2004-2005.

Results: Among 1991 women, 1209 (61%) were foreign born. Overall, 410 (21%) were eligible for vaccination, and of these 44 (11%) were vaccinated. Vaccination rates were not associated with maternal race/ethnicity or the existence of institutional standing-order vaccination policies. A vaccination order was recorded for 59% (240/410), but even in the presence of an order, only 17% (31/240) of those women were vaccinated.

Conclusions: Despite policies and standing orders to vaccinate, postpartum rubella vaccination rates were very low among all racial/ethnic subgroups in a sample of hospitals caring for high-risk, foreign-born women. These findings suggest that additional system-level interventions, such as comprehensive operational guidelines, must accompany standing orders to vaccinate rubella non-immune women postpartum.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Caribbean Region / ethnology
  • Emigration and Immigration
  • Female
  • Florida
  • Humans
  • Latin America / ethnology
  • Mass Screening
  • Postnatal Care*
  • Pregnancy
  • Pregnancy Complications, Infectious / immunology
  • Pregnancy Complications, Infectious / prevention & control*
  • Rubella / immunology
  • Rubella / prevention & control
  • Rubella Syndrome, Congenital / ethnology
  • Rubella Syndrome, Congenital / prevention & control*
  • Rubella Vaccine*
  • Vaccination / statistics & numerical data*


  • Rubella Vaccine