By Dr. Matthew Steed, Mercy family practice doctor and obstetrician (and father of two)
Q: I’m pregnant and don’t want to risk getting the flu shot. Do I have to get it?
A: Yes and here’s why. Pregnant women with influenza are more likely to develop severe illness and die than the general population. Recent pandemics (including 2009-2010) proved deadly for pregnant women. In the United States, pregnant women accounted for 5 percent of all deaths, even though they were only 1 percent of the population. It is believed changes in cardiovascular, pulmonary and immune systems that are routine during pregnancy might limit the body’s immune response making it more difficult to fight the flu. If the mother is sick enough to die, what happens to the baby? Keep reading.
Q: My mother told me the flu vaccine is not safe during pregnancy because it is a “live virus.” Is it safe for me and my baby? Which vaccine should I ask for?
A:The flu vaccine comes in both a “live” vaccine and an inactivated vaccine. It’s recommended that pregnant women receive the inactivated influenza vaccine and that the vaccine be given regardless of the trimester. Pregnant women should not receive live, attenuated vaccine (nasal spray). The inactivated influenza vaccine provides protection to not only mother but also to the infant for up to six months after birth. Infants have an increased risk for severe influenza illness and are not eligible for vaccination until 6 months. That’s why it’s so important for mothers to get the flu vaccine and reduce their baby’s risk of flu.
Q: Should I wait until the second trimester and what if I want to breastfeed?
A: No, you should get the Influenza vaccine today. It’s considered safe in the first trimester and while breast feeding. Recent analysis have suggested those in their third trimester and within four weeks postpartum are at increased risk of serious infection, so waiting until your third trimester is not a good idea. A breastfeeding mother can get the vaccine and a vaccinated mother passes immunity to the baby in her breast milk. This is very important since the baby cannot get the vaccine until 6 months old.
Q: What symptoms should I be aware of? How do I know if I have the flu?
A: The symptoms among pregnant women are similar to the non-pregnant population: fever, cough, rhinorrhea (runny nose), sore throat, headache, shortness of breath and myalgia (muscle pain). Current rapid diagnosis of influenza is possible with a “flu swab” but the test is not perfect and not reliable enough to rule out influenza virus infection. Current recommendations are that influenza should be treated based on a clinical diagnosis in the pregnant patient.
Q: What should I do if I was exposed to the flu or I think that I may have flu-like symptoms?
Antiviral prophylaxis is available and the decision to receive these medications must be made by a doctor, who will consider whether or not the exposure was significant. He or she will also factor in the risk to the mother and baby if they were to get a flu infection. If a pregnant women has been exposed to the flu or is having flu-like symptoms, she should call her doctor, the health department or the ER to discuss possible treatment.
Q: Why is getting the flu vaccine so important?
So what happens to the babies of mothers that are sick enough to die from the flu? During the H1N1 influenza season, a preterm mother with flu came to the hospital. It was not her first pregnancy. She was delivered by emergency c-section. After delivery she remained in critical condition and later was transferred to one of Arkansas’ best medical systems. The baby was transferred soon after delivery.
The mother lived for only a few more weeks after giving birth. The baby survived but suffered moderate permanent brain damage. The rest of her family and everyone else involved in her care are forever changed. Please get your Influenza shot today!
Dr. Steed’s number one passion is to care for the pregnancy and birthing needs of women. You may call him at the Mercy clinic at 479-338-5555 to begin your prenatal care and let him help you enjoy your pregnancy journey. His office is located in the Mercy Physician’s Plaza just off Interstate 540 in Rogers.
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