Latest On Immunization During Pregnancy
By Charles H Geneslaw, MD
March 02, 2018
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We are all hopeful that this flu season may at last be winding down a bit. Note that public health authorities recommend that, if you haven’t yet received a flu vaccine, it is still recommended to get one now. I want to briefly mention vaccination for a particularly important and vulnerable population of people–pregnant women. It’s relevant not only for this flu season but for those women who may become pregnant in the coming months and will be waiting to deliver as we enter flu season 2018-19.

A new study looked at over 400,000 infants born from 2004-14 who’s pregnant mothers were immunized against flu or with Tdap (against pertussis–“whooping cough”). The study found no increased risk in those infants for hospitalization or death in the 1st 6 months of life. The researchers reported that this is good news on top of previous similar reports that found Tdap or flu vaccine during pregnancy carried no increased risk to the baby for neonatal death, NICU admission, infections, respiratory, or neurologic complications, nor did it compromise infant growth out to 7 months and development out to 13 months.

They also noted significant benefits to the baby. Maternal anti-flu antibodies crossed the placenta and provided good protection to the baby during the 1st 6 months. Flu vaccine is not available 6 months, so this maternal transplacental transfer is all the antibody protection that these young babies can get. They found that maternal Tdap during pregnancy lowered subsequent respiratory hospitalizations in those newborns during their first 6 months as well. Of importance is that this data supports previous studies that drew similar conclusions regarding both flu vaccine http://europepmc.org/abstract/med/26238723 and Tdap for pertussis. https://www.ncbi.nlm.nih.gov/pubmed/25037990

The best time for a pregnant woman to receive Tdap is weeks 27-36. Flu shots should be done any time that a woman is pregnant during flu season (check with your obstetrician). Daddies get your shots too–its likely safer for you, your wife, and your baby (again, check with your doctor).

Flu mortality is up to 5x greater during pregnancy and of similarly greater risk for infants– in 2013-14 of 96 pediatric deaths 18 were in < 6 mo olds. A word about the previous data: flu is a real public health problem and we should take it seriously. Nevertheless, for healthy women of child bearing years and even for little infants, death from influenza in the US is rare. As I always stress: caution–yes, panic– NO.

To summarize: flu and Tdap vaccination for pregnant women is beneficial to the women, safe for the child ANDprovides important protection during baby’s first months of life. Ask me or your doctor for more information about it.

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