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The Flu Vaccine For Moms-To-Be

by Sue Hubbard, M.D.

I have the opportunity to see (not treat) a lot of pregnant women in my practice and they have been asking me my opinion about flu vaccine during pregnancy. They were inquiring about both seasonal flu vaccine and H1N1 (swine) flu vaccine.

The statistics surrounding pregnancy, influenza and secondary infections or other complications have been documented for several years. Retrospective studies done in the late 1990s showed that healthy pregnant women were more likely to have complications from influenza and had higher death rates than expected. This was especially noted in women in the last trimester of their pregnancies.

Due to these studies the CDC and ACOG (American College of Obstetrics and Gynecology) recommended that all pregnant women receive seasonal influenza vaccine. Despite these recommendations, more than 50 percent of OB’s recently surveyed do not routinely recommend flu vaccine and do not provide vaccine in their offices.

I see many expectant mothers who are totally surprised when I ask them if they have received a flu vaccine from their OB. In fact only 1 in 7 pregnant women are being vaccinated. This may be partially due to the fact that OB’s have not routinely been vaccine providers, as we pediatricians have been, and are now becoming more aware about universal recommendations for flu vaccine in pregnancy and are ordering vaccine for their patients to receive during routine obstetrical visits. Flu vaccine is safe throughout pregnancy.

This year is especially significant in that the H1N1 (swine) flu has also caused serious complications and deaths in pregnant women. The data shows that a disproportionate number of the deaths seen from swine flu (about 6 percent) were in pregnant women. Pregnant women are four times more likely to be hospitalized than other flu sufferers. This may be due physiological changes in lung function during pregnancy, as well as to differences in immune function. Regardless of the reasons, pregnancy in and of itself puts a woman at increased risk of serious complications, hospitalization and even death. Pregnancy is typically a time that we see the “the glow of pregnancy”, not complications or even death from having the flu.

As an added benefit of vaccination, the antibodies that a pregnant woman will produce after vaccination will then be transported across the placenta to help protect the newborn. Passive transport of maternal antibodies may be the best protection for a newborn in the first two months of life. This is especially important for those infants being born during the height of the flu season. As you know we cannot give an infant flu vaccine until they are six months of age. With both H1N1 influenza currently circulating throughout the U.S. and seasonal flu yet to come, now is the time to make sure that you are vaccinated, especially if you are pregnant.

Lastly, pregnant women should not receive live –attenuated flu vaccine (Flu-mist), but should receive the injectable flu vaccine for both seasonal flu and H1N1. You may receive both flu vaccines on the same day.  It is equally important for the father of the baby to be immunized against both types of flu to minimize the newborn’s risk of exposure as well. The best protection for a newborn is vaccination of those who will be caring for the infant during the flu season!!

That’s your daily dose, we’ll chat again soon.

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