Heilbrigðisskýrslur - 01.12.1969, Side 91

— 89 —
1969
second month and to 20 and 10 per cent in the third and fourth months
respectively. Recent evidence suggests that even after the fourth month
of pregnancy maternal rubella may give rise to hearing defects in the
child after birth.
3.56. With the realization of the substantial risk to the developing
fetus of maternal rubella during early pregnancy means were sought
of protecting women from the disease during this period. Human
normal immunoglobulin has been available for a number of years for
administration during the first 4 months of pregnancy to women who
are not known to be immune to the disease and have been in definite
close contact with infection. The report of a survey (Public Health
Laboratory Service, 1968b) showed, however, that immunoglobulin in the
dosage normally used (750 mg), when given in the first trimester of
Pregnancy to women who had been in contact with rubella, did not
appear to give any appreciable protection. In a subsequent survey in
which double the normal dosage of immunoglobulin (1,500 mg) was
used, there again appeared to be no prophylactic effect (Public Health
Laboratory Service, 1970b). It was clear, therefore, that the only reliable
protection against rubella was likely to be an effective rubella vaccine.
3.57. The discovery tiiat rubella virus could be grown on cell culture
Paved the way for the development of vaccines against rubella. A live
attenuated rubella virus vaccine was developed after passage of the
vL’Us through African green monkey kidney cells (Parkman, 1966).
Subsequently other live attenuated rubella vaccines were developed by
growing the virus on avian cell cultures (Parkman, Meyer and Hopps,
1969), primary rabbit kidney (Huygelen and Peetermans, 1967), duck
embryo (Buynak et ai., 1968) and human diploid fibroblast celis (Plot-
Lin et al., 1967). In the United Kingdom the Medical Research Council
carried out trials of vaccines prepared from rubella virus strains grown
°n rabbit kidney (Cendehill strain), duck embryo (HPV-77 DE5
strain) and human diploid tissue (RA 27/3 strain). All produced
satisfactory antibody responses in human subjects.
3-58. In January 1970, when a live attenuated vaccine prepared from
the Cendehill strain became available for general use in the United
Kingdom, doctors were so informed by letter (Department of Health
and Social Security, 1970d). An advisory group (now a Sub-committee
the Joint Committee on Vaccination and Immunization) was as-
•sernbled to consider the use of this vaccine. Their recommendations,
which were endorsed by the Joint Committee, were that live attenuated
rubella virus vaccine should be offered to all girls between their llth
and 14th birthdays. Vaccination of adult women of child-bearing age
yas not recommended as a routine because there would be a risk of
madvertently vaccinating a woman in early pregnancy, but it was left
12