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The Flu Shot In Pregnancy: Is It Worth It?

Flu season is here and once again pregnant women are getting a strong message that the flu shot is the healthiest choice.

Yesterday, the LA TIMES ran a piece about how the flu shot in pregnancy not only protects the mother from influenza, but it can help protect the baby after birth for up to six months: Babies born to mothers who had prenatal flu shots were 41% less likely to get the flu than babies of mothers who did not get the vaccine.

The Centers of Disease Control (CDC) recommend that all pregnant women receive the flu shot. Pregnant women are considered more vulnerable to the flu due to their weakened immune system; the shot they are being offered this year protects against H1N1 (swine flu) and the flu, it’s a dead virus, not the live virus used in the nasal spray.

From what I can tell most medical authorities are in agreement with the CDC. But there are detractors, the most legitimate of whom cite a Cochrane Database report questioning the efficacy of flu vaccines in general. Apparently, some of the influenza reviews are flawed. Argh. The vaccine debate can easily veer into the territory of paranoia. (I often wonder if, in this day and age,  pregnant women aren’t more vulnerable to upsetting controversy and fear-mondering–on all sides–than any virus around.)

There are also studies showing negative consequences for children of women who had the flu while pregnant. In the recently published and fantastic book ORIGINS: How the Nine Months Before Birth Shape The Rest Of Our Lives, Annie Paul looks into repercussions of the influenza pandemic of 1918. Those adults who were gestating during the flu outbreak were more likely to develop heart disease and live in poverty than those who were gestating before or after the pandemic. There is also a possible connection between influenza in early pregnancy and increased risk of schizophrenia in offspring.

The CDC doesn’t get into this territory, they really just talk about preventing complications of the flu in an immune-compromised population. Writing on behalf of the Mayo Clinic, Roger W. Harms (M.D.) had this to say:

“Pregnancy puts extra stress on your heart and lungs. Pregnancy can also affect your immune system. These factors increase the risk not only of getting the flu but of developing serious complications of the flu, such as pneumonia and respiratory distress. In turn, flu complications may lead to miscarriage, premature labor or other pregnancy complications. A flu shot can help prevent these potential problems.”

Ample support of the flu vaccine in pregnancy is reassuring. I also think that pregnant women– shot or no shot–benefit from good nutrition, hand-washing, common sense around sick people, reduced stress and some level of physical activity.

I got a flu shot for the first time ever when pregnant with my second. So did the whole family. My older son was in the habit of bringing home all kinds of lovely phlegmy gifts from the outside world and I didn’t want to (nor could I) avoid him. Looking at the evidence and following my gut, I concluded that the likelihood of seriously bad consequences of either choice was slim, slim, slim. So I went with the flow on this one, and got the vaccine. Fellow “being pregnant” blogger Danielle came to a similar conclusion, but made a different choice. What will you do?

photo: Steven Depolo/Fickr

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