Pregnant women should get the flu shot, regardless of how far along they are in their pregnancies — that’s the new recommendation from the American College of Obstetricians and Gynecologists (ACOG), who released the updated guidelines this week.
The new guidelines by ACOG also state that vaccination is important for women who are trying to become pregnant. Preventing the flu is an essential element of care during preconception, as well as during pregnancy and after delivery, according to a statement from ACOG.
“The flu virus is highly infectious and can be particularly dangerous to pregnant women, as it can cause pneumonia, premature labor and other complications,” said Dr. Laura Riley, chair of ACOG’s Immunization Expert Work Group, which developed the new guidelines.
Since the last time ACOG issued guidelines on the flu vaccine, in 2010, even more evidence has shown that the vaccine is safe for pregnant women, according to the new guidelines. “New data show the continued critical need for influenza vaccination during pregnancy,” and for providers to recommend and provide vaccinations,” the new guidelines say.
Why are pregnant women particularly vulnerable to flu-related complications? During pregnancy, a woman’s immune system changes, which results in increased opportunities for seasonal flu viruses to cause complications and serious illness, according to ACOG.
For example, during the 2009 H1N1 flu pandemic, pregnant women accounted for a disproportionate number of deaths. Additionally, the prevalence of preterm birth among women infected with H1N1 was 30 percent — more than double the usual rate in the U.S. (13 percent), according to the CDC. Other research has suggested the flu vaccine during pregnancy is linked with a lower risk of stillbirth.
Getting the flu shot when pregnant protects not only expectant mothers, but also babies, who can’t be vaccinated against influenza until they’re at least 6 months old. The babies of vaccinated women receive antibodies from their mothers while in the womb, helping to protect them against the flu until they’re old enough to be vaccinated themselves, according to ACOG.
Since 2009, influenza immunization rates for pregnant women have increased each year — from 15 percent to 50 percent — but experts at ACOG say that more work needs to be done to encourage all pregnant women to get the flu vaccine. For instance, some people may think pregnant women shouldn’t be vaccinated, but this is a myth, according to ACOG and the Centers for Disease Control and Prevention (CDC). The CDC recommends that everyone age 6 months and older, including pregnant women, receive a flu shot every year.
ACOG’s goal is to increase immunization rates for pregnant women in the United States well beyond the 50 percent mark. The flu shot, which does not contain any live virus, can be administered during any stage of pregnancy, ACOG said. Women who are breastfeeding or who have recently given birth should also get vaccinated early in the season, according to the new guidelines.
“Vaccination every year, early in the season and regardless of the state of pregnancy, is the best line of defense,” Riley said in a statement. In the United States, flu season typically starts in October and lasts through May. Pregnant women should plan to get vaccinated as early as possible, though the vaccine is available throughout flu season.
The ACOG also notes that pregnant women should receive the flu shot, not the nasal mist. The live attenuated version of the flu vaccine (the nasal mist) should not be given to pregnant women, they say.
The ACOG’s Committee Opinion #608, “Influenza Vaccination During Pregnancy,” will be published in the September issue of the journal Obstetrics & Gynecology.