Saule H, Enders G, Zeller J, Bernsau U. II. Kinderklinik im Krankenhauszweckverband, Augsburg, Federal Republic of Germany. Congenital rubella infection after previous immunity of the mother. Eur J Pediatr 1988 Feb;147(2):195-6.

A newborn boy was admitted with a congenital rubella infection. Seven years previously his mother had been vaccinated against rubella; 3 years previously rubella immunity had been confirmed. Therefore, intrauterine transmission must have occurred after maternal reinfection during pregnancy. Prenatal diagnosis of rubella embryopathy with serological methods after subclinical maternal reinfection is nearly impossible.

Bott LM, Eizenberg DH. Congenital rubella after successful vaccination. Med J Aust 1982 Jun 12;1(12):514-5.

We report a case of a patient who had a subclinical rubella infection in the first trimester of pregnancy which resulted in the delivery of a baby suffering from congenital rubella. Rubella virus vaccine, liver attenuated (Cendevax) vaccine had been administered to the mother nearly three years before, with proven seroconversion from a rubella haemagglutination-inhibition titre of 1:10 to 1:80.

Miron D, On A. Infectious disease Unit, Porya Hospital, Tiberias. Congenital rubella syndrome after maternal immunization [Article in Hebrew]. Harefuah 1992 Mar 1;122(5):291-3.

A 2.5 year-old girl was found to have congenital rubella syndrome. She presented with microcephaly, mild developmental delay, partial sensorineural deafness and cerebellar atrophy. Blood titers of rubella hemagglutinin were 1/256 and 1/512 (exclusively IgG). She had not had rubella, nor had she been immunized against it. The mother had been immunized against rubella 4 years before her pregnancy with this girl and 2 years later blood hemagglutinin titers were 1/32 and 1/64. She was neither exposed to nor suffered from rubella during the pregnancy. Reinfection with rubella, extremely rare during pregnancy, may occur in women whose hemagglutinin titers are lower than 1/64. Rubella also occurs in women who have been immunized but whose titers, similarly, are lower than 1/64. In some of these women the disease is asymptomatic. In general, reinfection does not result in fetal injury, but cases have been described in which babies of mothers infected in pregnancy were born suffering from various degrees of congenital rubella syndrome.

Das BD, Lakhani P, Kurtz JB, Hunter N, Watson BE, Cartwright KA, Caul EO, Roome AP. Department of Microbiology, Milton Keynes General Hospital. Congenital rubella after previous maternal immunity. Arch Dis Child 1990 May;65(5):545-6

Two mothers who had asymptomatic rubella infection in pregnancy gave birth to severely affected infants. In both, the presence of preexisting antibody was well documented, although it could not be established whether it was the result of vaccine or natural infection.