Pregnant? Get a Flu Shot

Influenza is a killer, with tens of thousands of deaths attributed to this common viral infection each year in the United States alone, and that's just from garden variety, seasonal flu.  Add a pandemic strain to the mix and the numbers quickly become stratospheric.  Who usually dies?  The very young and the very old. 

If you're pregnant, this brief recitation of the facts should compel you to immediately receive a flu shot.  And a study in this issue of Archives of Pediatric and Adolescent Medicine confirms what other, less rigorous studies have already intimated: mothers who receive the vaccine provide protective antibodies to their unborn children.  When those infants are born and their own immune systems are just getting up to speed, they are more protected against the flu and its respiratory complications, including the need to be hospitalized, than infants whose mothers declined to be vaccinated. 

The study observed over 1100 infant/mother pairs, both those where the mother received a flu shot while pregnant and those who did not.  Subsequent development of flu-like illness and the need for hospitalization secondary to the illness were calculated for each group.  There was a 41% reduction in risk of laboratory-confirmed influenza infection and a 39% reduced risk in the need to be hospitalized among infants whose mothers were vaccinated.

The clear message is, ladies, roll up your sleeves. There are no known risks in being vaccinated during pregnancy, either for mother or fetus.  The risk of being pregnant and developing severe flu complications is known, however.  Pregnant women were one of the severe risk groups of patients in last year's H1N1 pandemic and comprised a disproportionate number of the deaths associated with this virus strain.

Why are women who are pregnant so reluctant to be vaccinated?  Myth and urban legend seem to drive the resistance, as any examination of studies to date refutes any downside.  Pregnant women are cautioned repeatedly to avoid almost everything and anything, so should immunization avoidance come as any surprise?  Perhaps not, but here is a clear case where rationality should prevail, and all women who are pregnant should expect to receive a flu shot along with prenatal vitamins and regular medical care.

Rant over.  Other topics in this week's podcast include screening for common cancers among those who are HIV positive in this issue of Annals of Internal Medicine, with cancer surveillance in adult survivors of childhood cancer in the same issue, and advanced radiology tests in the ED in JAMA.  Until next week, y'all live well.

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