Vaccination is the only reliable way to prevent rubella. A single dose of the MMR (measles, mumps, and rubella) vaccine is 97% effective against rubella, and the protection lasts decades. Most people in the U.S. receive two doses during childhood, but adults who missed those doses or lack proof of immunity can still get vaccinated at any age.
How the Vaccine Works
The MMR vaccine contains a weakened, live form of the rubella virus. It’s too weak to cause illness, but strong enough to trigger your immune system into producing protective antibodies. Those antibodies remain detectable in 90% to 100% of vaccinated individuals even 11 to 13 years after their initial dose, providing long-lasting defense without needing regular boosters.
Because the vaccine is so effective, rubella has been eliminated from entire regions. The WHO has verified elimination across the Americas, and in 2025 confirmed that Japan and 21 Pacific island countries have also achieved rubella elimination. These successes depend on maintaining high vaccination coverage. The herd immunity threshold for rubella is 83% to 85%, meaning that proportion of a population needs to be immune to stop the virus from spreading through a community.
Vaccination Schedule for Children
The CDC recommends two doses of the MMR vaccine for children. The first dose is given between 12 and 15 months of age, and the second between 4 and 6 years. The earliest a child can receive the vaccine is 12 months old. The second dose isn’t a booster in the traditional sense. It exists to catch the small percentage of children whose immune systems didn’t respond fully to the first dose.
For families planning international travel with an infant, the timeline shifts. Babies between 6 and 11 months old should receive one dose of MMR before the trip. That early dose doesn’t count toward the standard schedule, though, so the child still needs two more doses starting after their first birthday.
What Adults Need to Know
If you were born before routine rubella vaccination or you’re unsure whether you were vaccinated as a child, you can get the MMR vaccine as an adult. There’s no harm in receiving the vaccine even if you already have immunity. One dose is typically sufficient for adults who aren’t in a high-risk group.
A simple blood test can confirm whether you’re immune. The test measures rubella IgG antibodies in your blood. A level above 10 IU/mL is considered protective in the United States. This test is particularly important if you’re planning a pregnancy, working in healthcare, or preparing for international travel to areas where rubella still circulates.
Rubella Prevention and Pregnancy
Rubella poses its greatest danger during pregnancy. Infection in the first trimester can cause congenital rubella syndrome, leading to heart defects, hearing loss, vision problems, and developmental delays in the baby. This is why rubella immunity screening is a standard part of prenatal care.
Your doctor will check your rubella IgG levels before or during pregnancy. If the test shows you’re not immune, you cannot receive the MMR vaccine while pregnant because it contains a live virus and poses a theoretical risk to the fetus. The vaccine should be given either before conception (with at least four weeks between vaccination and becoming pregnant) or immediately after delivery. If you’re found to be non-immune during pregnancy, the priority is avoiding contact with anyone who has rubella symptoms and getting vaccinated as soon as possible after giving birth to protect future pregnancies.
Routine IgM screening during pregnancy is not recommended for women without symptoms or known exposure. False positive results can occur and lead to unnecessary anxiety and follow-up testing.
Protecting Yourself While Traveling
Rubella has been eliminated in many countries, but it still circulates in parts of Africa, Southeast Asia, and the Eastern Mediterranean. Anyone traveling internationally should be fully vaccinated before departure. If you haven’t had two doses of the MMR vaccine and you’re heading to a region where rubella is endemic, getting vaccinated at least two weeks before your trip gives your body time to build protection.
Who Should Not Get the Vaccine
Because the MMR vaccine uses a live virus, certain groups need to avoid it or delay it. These include:
- Pregnant women, due to the theoretical risk to the developing fetus
- People with severe immune suppression, including those on high-dose immunosuppressive therapy for more than 14 consecutive days, those with HIV and severely low CD4 counts, or those undergoing chemotherapy
- Anyone with a history of severe allergic reaction to a previous MMR dose or to vaccine components like neomycin or gelatin
- People with a current moderate to severe illness, who should wait until they recover before being vaccinated
- Individuals with congenital immunodeficiency disorders or a family history of hereditary immunodeficiency, unless lab testing confirms their immune system functions normally
For people in these categories, the best protection comes from the people around them being vaccinated. When enough of the surrounding population is immune, the virus can’t find new hosts and can’t reach vulnerable individuals.
Reducing Spread if Someone Is Infected
A person with rubella is contagious from 7 days before the rash appears to 7 days after. That pre-rash contagious window makes rubella tricky to contain, since people can spread the virus before they know they’re sick. If someone in your household or workplace is diagnosed, anyone who isn’t vaccinated or immune should avoid close contact during that full 14-day contagious window. Rubella spreads through respiratory droplets from coughing and sneezing, so the same precautions that limit cold and flu transmission (hand washing, avoiding shared utensils, staying away from infected individuals) help reduce risk. But none of these measures come close to the protection vaccination provides.