Talk to Your Pregnant Patients about Immunization

As an ob-gyn, I believe in the importance of vaccines. They are one of our best options for preventing the spread of certain infectious diseases. Usually, this is the time of year that we start reminding women to get their annual flu vaccine, especially during pregnancy. But based on the troubling recent reports of whooping cough (pertussis), measles, and mumps outbreaks across the country, it’s clear that flu isn’t the only vaccine reminder that our patients need.

These recent disease outbreaks are worrisome, especially since pertussis, measles, and mumps had been extremely rare in the US. Because of many years of widespread vaccination against these diseases in the US, the population had developed “herd immunity”—because most of the “herd” was immunized and not susceptible to infection, the few not vaccinated still received protection. But in recent years, anti-vaccine sentiments have grown, and more and more children are skipping important immunizations, leaving many vulnerable to these diseases. Outbreaks often start when an unvaccinated person comes in contact with a disease (usually during a trip abroad) and brings it back to a community where a number of people are unvaccinated.

Pregnant women and infants are hit especially hard by disease outbreaks. Pregnancy causes changes to the immune system that make women more vulnerable to infections like pertussis and flu, and most vaccines cannot be administered to infants until they are about six months old. Vaccination of the mother during pregnancy becomes especially important because it provides protection for both mom and baby. Ob-gyns have a real opportunity to increase vaccination rates during pregnancy, a time when we see our patients more regularly and have repeated opportunities to discuss the benefits of immunization. While the measles, mumps, and rubella vaccine should not be given until after delivery, the tetanus, diphtheria, and pertussis (Tdap) vaccine can be given during pregnancy. The Centers for Disease Control and Prevention now recommends that all pregnant women receive the Tdap vaccine with every pregnancy. ACOG also recently issued updated recommendations on Tdap immunization for pregnant women.

Some women may worry about the safety of vaccines. Research has overwhelmingly shown vaccines are safe and are not linked with autism. Because of all that’s at stake, ethical considerations prohibit extensive scientific and medical research during pregnancy. However, millions of pregnant women have received immunizations over the years with minimal side effects and no serious adverse events linked to the vaccines. Learn more on ACOG’s immunization website: www.immunizationforwomen.org.

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Guest Blog: Pregnant Women—Avoid the Flu, Get Vaccinated

Laura E. Riley, MD

Preventing flu when you’re pregnant is an essential element of prenatal care, and the best way to do that is to get your annual flu shot. Seasonal influenza is a virus that spreads easily and is most common in the US between October and May, often peaking in February.

It is especially important for pregnant women to be vaccinated because they can become sick enough from the flu that it can lead to severe lung infections requiring hospitalization and preterm delivery. I offer flu shots to all my pregnant patients and those who are considering becoming pregnant. In fact, ACOG and the Centers for Disease Control and Prevention recommend that everyone older than six months of age receive the flu vaccine every year.

It’s important that pregnant women get the flu shot, not the nose spray version of the vaccine, which contains a live attenuated virus. The flu shot is safe for pregnant women and their unborn child during any trimester; it is also safe after delivery and for breastfeeding women. Flu vaccination will not only protect new mothers but can provide protection to their babies in the first six months of their life. Family members, caregivers, and others who will be around the baby should also be vaccinated.

Ob-gyns should offer the flu shot to all their pregnant patients. During pregnancy, the flu shot is the best protection there is against serious illness from seasonal influenza.

The flu vaccine is now widely available at doctors’ offices, clinics, pharmacies, and health departments. To find a vaccination location near you, see this HealthMap Vaccine Finder.

For more information about the flu vaccine, other vaccine-preventable diseases, and the immunization needs of special populations, visit ACOG’s Immunization for Women website.

Laura E. Riley, MD, is chair of The American College of Obstetricians and Gynecologists’ Immunization Expert Work Group. Dr. Riley is director of Labor and Delivery at Massachusetts General Hospital in Boston.