The Doctors Next Door

Should Pregnant Women Really Get the H1N1 Vaccine?

 

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Last week, I was talking to a nurse who is looking forward to a new grandchild in about a month or so. The obstetrician had told her pregnant daughter-in-law that "by protocol, he has to tell her that she is supposed to get the vaccine, but to tell her the truth, if it was his wife or daughter who was pregnant, he wouldn't let them get the vaccine."

 

 

And after a personal endorsement like that from an obstetrician, who would get the vaccine? 

So

 what's the real scoop? Is he right? Or is the CDC right?

(Let me give you a hint...if you're a betting person, put all your money on the CDC.)

Yes, pregnant women really should get the H1N1 vaccine.

Oh, hold on a minute, I think I hear something...yep, it's that obstetrician wondering how he just lost his money on that bet.

Here's three reasons:

1. Pregnant women are at higher risk of influenza-related morbidity and mortality as compared to non-pregnant women. Previous seasonal influenza epidemics and pandemics have shown this to be true. In pregnancy, the normal physiologic changes in the immune, cardiovascular and respiratory systems increase the risk of complications from the flu. Pregnant women with underlying medical conditions like asthma or diabetes are at an even higher risk.

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2. We also know that this new H1N1 influenza virus has already caused more severe disease and death in pregnant women. As a matter of fact, during about a month long study period last spring when H1N1 first appeared, pregnant women accounted for only 0.62% of confirmed and probable H1N1 cases. However, they accounted for 13% of the deaths. Pregnant women certainly had a disproportionate number of deaths and that's a BIG deal. We have no reason to believe it will be any different this season.

 

3. The same study also showed that pregnant women with H1N1 were hospitalized four times more than the general population with H1N1.

 The H1N1 vaccine will be available soon. The CDC and the Advisory Committee on Immunization Practices (ACIP) are initially targeting the H1N1 vaccine for 5 groups at higher risk for H1N1 infection and complications. Pregnant women are one of those groups.

If the initial vaccine availability is insufficient for everyone in those 5 groups (which is about 159 million people), the ACIP has pared the list down even further to those at the highest of the high risk. Pregnant women still make the cut.

Valerie Post, a pregnant 24-year old woman in Tampa, tested positive for the H1N1 virus. An emergency C-section was done in attempts to avoid having the virus affect her baby. She was never able to come off of life support after the surgery and died last month, leaving her two children and her husband. It's a part of medicine I hate the most. My thoughts and prayers go out to her family.  

At that time, the vaccine wasn't available for Valerie. But it will be soon. If you are pregnant, go get it. The benefits far outweigh any concerns about potential risks. And yes, if I were pregnant, I'd get it. 

For more information about the H1N1 vaccine and pregnancy, click here for the CDC's recent information as of October 2.

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