Influenza vaccination in pregnancy
Experience with prior annual seasonal influenza epidemics and the pandemic in 2009 have demonstrated clearly that pregnant women are at increased risk of morbidity and mortality from influenza.1 2 3
Last year, under the National Immunisation Program, free seasonal influenza vaccine was offered to all pregnant women throughout Australia. Despite this, a recent WA Department of Health survey found that only 25% of all pregnant women in Western Australia were vaccinated against flu while they were pregnant and just 38% said they were advised by their antenatal health care provider to be vaccinated.
We have to do better—influenza vaccination of pregnant women is ‘standard of care’ in Australia. The National Health and Medical Research Council (NHMRC) recommends that the influenza vaccine be offered to all pregnant women who will be in the second or third trimester during the influenza season, including those in the first trimester at the time of vaccination.7
Why pregnant women should receive seasonal influenza vaccine
- Influenza vaccination of pregnant women reduces illness in both the mother and newborn. A randomised controlled trial in which pregnant women were vaccinated against influenza, demonstrated a 29% reduction in respiratory illness with fever in the pregnant women. It also showed that infants born to vaccinated women had a 63% reduction in laboratory-confirmed influenza illness during their first 6 months of life.4
- Influenza vaccination of pregnant women reduces hospitalisations. Influenza vaccination is estimated to prevent 1 to 2 hospitalisations per 1000 women vaccinated during the second or third trimester.5
- Caregivers of newborns are potential sources of transmission of influenza. Vaccinating everyone who lives with—or cares for—infants less than 6 months of age (who are too young to receive the vaccine themselves) is the best way to prevent these children from getting influenza.6
- The influenza vaccine is safe for pregnant women. There is no evidence of congenital defects or adverse effects on the fetus of women who are vaccinated against influenza in pregnancy.6 8 Seasonal influenza vaccines can be given to pregnant women in any trimester.
Encouraging pregnant women to get the seasonal influenza vaccine can help to protect them and their newborns from influenza. Health providers play a crucial role in addressing concerns pregnant women may have about influenza vaccination. Preventing influenza among pregnant women can save lives.
- Irving WL, James DK, Stephenson T, et al. Influenza virus infection in the second and third trimesters of pregnancy: a clinical and seroepidemiological study. BJOG: An International Journal of Obstetrics & Gynaecology 2000;107:1282–9.
- McNeil SA, Dodds L, Allen VM, Scott J, Halperin B, MacDonald N. Influenza vaccine programs and pregnancy: new Canadian evidence for immunization. J Obstet Gynaecol Can. 2007 Aug;29(8):674–6.
- World Health Organization. Pandemic Influenza in Pregnant Women. Available at the World Health Organization website (external site) .
- Zaman K, Roy E, Arifeen SE, Rahman M, Raqib R, Wilson E, Omer SB, Shahid NS, Breiman RF, Steinhoff MC. Effectiveness of maternal influenza immunization in mothers and infants. (external site) N Engl J Med. 2008 Oct 9;359(15):1555–64. Epub 2008 Sep 17. 1.
- Neuzil KM, Reed GW, Mitchel EF, Simonsen L, Griffin MR. Impact of influenza on acute cardiopulmonary hospitalizations in pregnant women. American Journal of Epidemiology 1998;148:1094–102.
- CDC. Prevention and Control of Seasonal Influenza with Vaccines. Recommendations of the Advisory Committee on Immunization Practices (ACIP), July 31, 2009 / 58(RR08);1–52. Available at the US Centers for Disease Control and Prevention website (external site).
- The Australian Immunisation Handbook 9th Edition 2008, National Health and Medical Research Council. Available at the Immunise Australia Program website (external site).
- Letter from Professor Jim Bishop, Chief Medical Officer, Australia, 2 November 2009.