Dr. Ashley Roman: September has arrived, summer is over, the kids are going back to school, and flu season is upon us. But, if last spring is any indication, this year's flu season has the potential to be exceptionally scary as we face a new dangerous strain -- the swine flu -- which seems to be especially hazardous for pregnant women. Having taken care of a number of pregnant women with the swine flu, I can tell you that contracting it during pregnancy is a very serious matter. Some quick factoids derived from the US’ experience with swine flu last spring:
• One in three pregnant women who were infected with the swine flu required hospitalization, primarily due to severe respiratory illness.
• Pregnant women appear to be at increased risk of dying from the swine flu. According to the Centers for Disease Control (CDC), six percent of swine flu deaths were in pregnant women, whereas only one percent of the general population was pregnant.
• Both seasonal flu and swine flu increase the risk of preterm birth.
What can we do to prevent getting the flu this year? Both the CDC and the American College of Obstetricians and Gynecologists are recommending that all pregnant women get the seasonal flu vaccine (available now) and the swine flu vaccine (likely available in October) regardless of which trimester they are in. There are several kinds of flu vaccine. The seasonal flu vaccine and swine flu vaccine that are safe in pregnancy are the shots which are made of inactivated virus. For moms concerned about thimerosol in vaccines, there will be thimerosol-free flu shots available for both the seasonal flu and swine flu. Pregnant women should not get the nasal spray flu vaccine, which is made of live attenuated virus and has not been shown to be safe in pregnancy.
As the mother of two small children myself, including a 2-month-old, I know that it can be a difficult decision whether or not to get the shots. As an obstetrician, I hear several concerns from my patients about getting the shots. The primary concern I have heard has to do with the fact that the swine flu vaccine is a "new" vaccine -- how do we know it will be safe and effective in pregnant women? An important point to remember is that every year's seasonal flu shot is technically a "new" vaccine; it targets various strains of the seasonal flu but involves a similar preparation process. The swine flu shot is no different. We have many years of experience with this preparation process, and it appears to be safe in pregnancy. In terms of efficacy, studies are being done right now in pregnant women to determine the effectiveness and the proper dosing regimen.
Another important point is that the benefits of the flu vaccine don't just apply to the mother. A study of the seasonal flu vaccine that was published a year ago showed that infants of mothers who got the flu shot during pregnancy were less likely to have respiratory illness and fever in the first six months of life. This is an important finding since infants cannot get the flu shot until they are six months old. So, by getting the flu shot, you’re helping yourself and your baby.
The bottom line is, if you’re pregnant, you should get both the seasonal and swine flu vaccines. The following are some resources on preventing the flu this season:
> The American College of Obstetricians and Gynecologists
> The Centers for Disease Control
-- September 10, 2009.
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