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GGD Gelderland-Zuid, in collaboration with the Radboudumc and Maastricht University, conducted research into personal experiences of unvaccinated orthodox Protestant women with rubella. It looked at whether women wanted to be tested to see if they were protected against rubella. And if they are not protected, whether they would want to be vaccinated. Does an unvaccinated woman get rubella during pregnancy? If so, her unborn baby may develop congenital rubella syndrome. This can lead to serious birth defects. The last rubella epidemic in the Netherlands was almost 20 years ago now. As a result, the likelihood of a new rubella epidemic is high.
The researchers advise obstetricians and other health care providers to inform unvaccinated women about rubella, the antibody test and vaccination. Women who are unsure whether to be tested and vaccinated should be given help in making this choice, according to the researchers.
The survey
For the study, 167 unvaccinated orthodox Protestant women between the ages of 18 and 40 completed a questionnaire. In addition, 10 women were interviewed. The questionnaires and interviews showed that three-quarters (74%) of the women had experience with rubella. Nearly 70% of the women think she can no longer get rubella. And 24% of women have doubts about this. Most women who are (almost) certain they have had rubella knew this because their parents told them. It was not always clear whether it was really rubella or some other childhood disease which causes a rash. Only a few women were ever offered a rubella antibody test.
More than half of the women (56%) were unsure if they would have a rubella antibody test done if it was offered. 23% of women would definitely not want the test. And 21% of women would definitely want the test.
Would the test show that she could still get rubella? Then 41% of women would not want a rubella vaccination. Only 4% of women would want it. The rest of the women (55%) are unsure.
Women cite different religious reasons for not wanting to be vaccinated. In addition, they do not perceive rubella as a danger because there is no rubella at present. Would there be a rubella outbreak? Then the women would want information about rubella and how to prevent infection.
Among orthodox Protestant women
Rubella is known as a mild childhood disease. It is especially dangerous for pregnant women and their unborn child. Rubella is preventable with vaccination. According to the National Vaccination Program, children are offered two BMR (mumps-mumps-rubella) vaccinations at ages 14 months and 9 years. Vaccinated children and adults cannot contract the disease again. Also a person who went through the disease cannot get it again afterwards. This person then has antibodies against rubella.
Unvaccinated women of childbearing age are not routinely tested for antibodies. The advice to obstetricians is to test unvaccinated women for rubella during the first trimester of pregnancy. If the woman has no antibodies, she can be vaccinated against rubella after pregnancy. With the vaccination, she is then protected against rubella for a subsequent pregnancy.
Outbreaks of infectious diseases occur regularly within the orthodox Prostestant community in the Netherlands. The last rubella epidemic in the Netherlands was in 2004-2005. Then 11 children were born with congenital defects because their mother contracted rubella during pregnancy.
Read the publication about the study in BMC Public Health here
