The influenza virus, better known as the flu, has been proven over and over to have the potential to cause serious disease in pregnancy. That includes an increased risk that when pregnant women “catch” the flu, they may require admission to the intensive care unit, require a ventilator and, less commonly, even death. It’s serious. Babies of women who are infected with the flu during pregnancy are more likely to be born prematurely and are at increased risk for stillbirth.
We recommend the flu vaccine at any point in pregnancy and offer the single dose, preservative free vaccine in our office to all pregnant women (with the exception of those who have a medical reason not to get it.) A common misconception is that the vaccine causes the flu - it does not. Another misconception is that it is not safe for the developing baby to be exposed to the vaccine itself or the immune response it generates. There is no evidence to support this fear in almost 50 years of administrating this vaccine and close follow up of those receiving it.
We recommend the flu shot, which is an inactivated virus. The Flumist is a live attenuated virus that is not recommended in pregnancy.
Your family members should also receive the vaccine as they can pass the flu on to a newborn who has not yet gotten the vaccine. Babies can suffer severe complications if they are infected with the virus before they can receive the vaccine.
The other vaccine we recommend during pregnancy is the Tdap booster. The benefit of the pertussis booster outweighs any perceived risk. Pertussis, or the whooping cough, is at epidemic levels especially on the west coast including Washington State. That may be due to our gradually decreasing immunity from childhood vaccine but also low vaccine rates in some communities.
If you get the whooping cough it is usually just a severe cough and cold like symptoms. If your baby catches the bacteria, it can be life threatening and in fact several babies have died in the last few years as a result of infections. Babies don’t complete their vaccine series and become immune to the disease until after 6 months from birth, but prior to this is when they are most vulnerable to the severe complications of the disease. It is common for these infants to have serious enough problems to be hospitalized; and of those hospitalized, 1-2 in 100 will die.
For these reasons we recommend you receive the pertussis vaccine at about 28-37 weeks gestation. This will give your body time to make antibodies to the virus that cross the placenta during the pregnancy to protect the baby after it is born and in your breast milk during the time you are breastfeeding. (Which we encourage all new moms to do). We even recommend the vaccine during each pregnancy so that each child can benefit from the protection it affords. Receiving their vaccine during pregnancy has proven more effective than just recommending vaccinations after delivery for you and for family/caregivers. This method has been called cocooning.
We know that women want to protect their babies from harm and we feel that being immunized during pregnancy is a critical step in supporting this effort.
If you are interested in reading more about these vaccines, learn more from the Centers for Disease Control; Institute of Medicine; and the American College of Obstetricians and Gynecologists.