Baby & Toddler - December 2008
Flu Shots Recommended During Pregnancy
By Elizabeth Heubeck
Have you gotten your flu shot yet? You may think you can sit this season out
because you’re pregnant. But you shouldn’t.
During pregnancy, your risk of complications from the flu increases. What’s
more, a flu shot will not only protect you, but it will also protect your
newborn from the flu during the first few months of life. If this news comes as
a surprise to you, you’re not alone.
Misconceptions abound about the effects of the flu shot during pregnancy. Many
pregnant women don’t recognize the importance of getting a flu shot; countless
moms-to-be even think it may be harmful. That’s according to a recent survey of
528 U.S. women either pregnant or with a child under 2 years of age.
Specifically, an overwhelming 75 percent of respondents were unaware or unsure
of long-standing national health recommendations that women receive a flu shot
during pregnancy. Only 20 percent of respondents who were pregnant planned to
get a flu shot during influenza season. These findings, released in October
2008, were culled from a Harris Interactive survey conducted for the non-profit
National Women’s Health Resource Center (NWHRC).
The survey findings come in the midst of the public information campaign
Flu-Free and a Mom-to-BE: Protect Yourself, Protect Your Baby—Get a Flu
Shot, sponsored by NWHRC and the Association of Women’s Health, Obstetrics, and
Neonatal Nurses (AWHONN). The campaign aims to drive home a decade-old message
of the importance of the flu shot for moms-to-be, combined with an exciting new
message of how it boosts babies’ immunity during the first few months of life.
“The Centers for Disease Control has been recommending the flu vaccine during
pregnancy since 1998. Many gynecologists and nurse midwives have been regularly
recommending and providing it,” says Catherine Ruhl, a certified nurse midwife
and associate director of Women’s Health Programs at AWHONN.
And yet, a disconnect remains between pregnant women’s perceptions regarding
the flu shot and health providers’ recommendations. To bridge this information
gap, Ruhl urges pregnant moms to get a flu shot based on the following
Why Extra Protection While Pregnant
Ruhl and other health care providers
routinely encounter pregnant women who think: “I’m healthy, I feel great, and I
rarely get sick—why should I get a flu shot just because I’m pregnant?”
The reality is that physiological changes during pregnancy lower your immunity,
placing you at higher risk for developing the flu and serious flu-related
complications such as pneumonia.
During the third trimester, the risks increase. A high fever and dehydration,
oftentimes associated with the flu, can increase your risk for premature
contractions. It may also slightly elevate your baby’s risk of birth defects. A
study out of Vanderbuilt University School of Medicine reported that women in
their third trimester are three to four times more likely than postpartum women
to be hospitalized for a cardiopulmonary illness during flu season.
Double Bonus: Newborn Immunity Booster
Getting the flu shot during pregnancy not
only protects you from developing the flu, it offers protection to your newborn
during the first few months of life.
Here’s how it works. The antibodies (or the proteins made by the body to fight
infection) that you develop when you get a flu shot cross through the placenta
to your fetus, where they remain until up to six months after your baby is
This information was discovered only recently—a study published in the
September 2008 issue of the New England Journal of Medicine
yielded the first tangible evidence to date of this. In the study, infants up
to 6 months of age whose mothers received a flu shot during pregnancy lowered
their rate of influenza virus by 63 percent; they were also 29 percent less
likely to develop a respiratory illness with fever, compared to infants whose
mothers hadn’t received a flu shot during pregnancy.
This is good news for two reasons. First, the flu shot isn’t recommended for
infants younger than 6 months of age. Therefore, receiving Mom’s antibodies in
utero offers protection young babies wouldn’t otherwise get. Secondly, newborn infants haven’t yet built up
their own immune systems to fight infections, making moms’ antibodies their
sole source of immunity.
About the Mercury Question
Fears associated with flu
shots—specifically, that they may contain thimerosal (a preservative with
mercury)—may be one more factor preventing women from getting the flu
Ruhl responds to these concerns: “Despite 80 years of data, researchers have
never proven that there’s a concern with thimerosal.”
However, six states have passed laws that ban thimerosal for children and
pregnant women. Maryland is not one of these six, but it is among several
states currently proposing the ban of thimerosal for children and pregnant
If you would prefer, ask your healthcare provider specifically for a thimerosal-free
flu shot. BC
Fast Facts about the Flu and Flu Shot during Pregnancy
Inactive flu vaccines (delivered via
needle) are safe during any stage of pregnancy.
Live flu vaccine (delivered via nasal
spray) should NOT be administered during pregnancy.
Getting a flu shot during pregnancy reduces
a woman’s chance of developing the flu and related complications.
Infants whose mothers receive a flu shot
during pregnancy are less likely to develop influenza and respiratory illnesses
during the first six months of life.
Sources: National Women’s Health
Resource Center (NWHRC); the Association of Women’s Health, Obstetrics and
Neonatal Nurses (AWHONN); and “Effectiveness of Maternal Influenza Immunization
in Mothers and Infants,” by K. Zaman et al., New England Journal of
Medicine, Oct. 9, 2008.
© Baltimore’s Child Inc. December 2008