Here’s how worried the Centers for Disease Control is about the H1N1 flu in pregnant women: It is the very first thing you see on their home page, above all other diseases and conditions. Clicking on the words “H1N1 and pregnancy” takes you to a page filled with information. Prominently displayed in bold type is this caution:
“Pregnant women can get seriously ill with the 2009 H1N1 influenza virus (sometimes called “novel H1N1 flu” or “swine flu”). Learn how to protect yourself and your baby and what to do if you have symptoms of the flu.”
And, just beneath that: “A pregnant woman who gets any type of flu has a greater chance for serious health problems. Compared with people in general who get 2009 H1N1 flu, pregnant women with 2009 H1N1 flu are more likely to be admitted to hospitals. Pregnant women are also more likely to have serious illness and can die from 2009 H1N1 flu. To protect yourself and your baby, make sure to get both the 2009 H1N1 flu shot and the seasonal flu shot.”
Still, there are moms-to-be who worry whether getting the vaccine is the safest thing to do for themselves and their baby. They have spent weeks or months being hyper-careful about caffeine, alcohol and medicines that could harm the developing fetus, and they are unsure about this. Here’s some of the most vital information about the vaccines, the flu and the impact on a pregnant woman’s body.
Why am I so vulnerable? I feel so healthy!
For a few reasons. Your body’s immunities are down right now because of your pregnancy. Your lung capacity is reduced because the growing baby takes more and more room. And those factors make it easier for a virus to turn into bacterial pneumonia. In October, the CDC announced that 100 pregnant women had been hospitalized in intensive care with the swine flu, and 28 had died, as of the end of August. That’s nearly a 30% death rate among those who reach intensive care.
Do I get the shot or nasal vaccine?
Pregnant women should get the shot. It is made with killed flu virus and given with a needle. You cannot get the flu from this vaccine. The nasal spray vaccine is NOT approved for pregnant women.
Does it matter which trimester I’m in?
No. The CDC says the shot can be given any time during pregnancy.
What about mercury in the shots?
“There is no evidence that thimerosal (a mercury preservative in vaccine that comes in multi-dose vials) is harmful to a pregnant woman or a fetus,” the CDC says. “However, because some women are concerned about thimerosal during pregnancy, vaccine companies are making preservative-free seasonal flu vaccine and 2009 H1N1 flu vaccine in single dose syringes for pregnant women and small children. CDC advises pregnant women to get flu shots either with or without thimerosal.”
If you are concerned about thimerosal, call your doctor’s office or the location where you hope to get your flu shot and be sure they have the vaccines made without the preservative.
Does the swine flu shot have an adjuvant or squalene in it?
Adjuvants are ingredients that are sometimes added to a vaccine to make it more effective. Squalene is an example of an adjuvant. There are no adjuvants in either the H1N1 or the 2009 seasonal flu shot used in the United States.
Are there any side effects to the shot?
Many people have no side effects other than irritation to the place where the shot was given. Others may have headaches, muscle aches, fever, nausea or fatigue. Those who have ever had an allergic reaction to a vaccine should tell their health care professional before getting a shot. And if you have serious egg allergies, do not get the shot unless your doctor says it's OK for you.
I’ve already had the baby and I’m breastfeeding. What now?
You should get both the seasonal and H1N1 flu shots. They will protect you; your body will create antibodies to the viruses, and you then can pass some protection on to your infant (babies themselves cannot be vaccinated until they are 6 months old).
I have the flu. What now?
Call your doctor, now. You need to get started on treatment, most likely with a prescription for Tamiflu, an anti-viral medicine. It works best when started within 48 hours of the beginning of your symptoms.
Is the anti-viral medicine safe for the baby?
So far, there are no studies suggesting harm to a pregnant woman or her unborn baby if she takes antiviral medicines. The threat from the flu itself is greater for both mom and baby.
What about seasonal flu?
The seasonal flu shot is important, too. Pregnant women should get both, the CDC says. But we have the least immunity to H1N1, so it’s the top priority.
Here are a few links that specifically discuss pregnancy and the swine flu. The news articles are only those that are thorough and well-sourced.
This is the CDC page:
http://www.cdc.gov/Features/PregnantH1N1Flu/
A CNN article on a pregnant mom and her pregnant daughter both battling the H1N1 flu:
http://www.cnn.com/2009/HEALTH/11/02/mom.daughter.pregnant.h1n1/index.html
An ABC News report on how flu vaccinations are leading to bigger babies who are more likely to be able to fight off the flu themselves:
http://abcnews.go.com/Health/SwineFluNews/flu-vaccine-benefits-moms-babies/story?id=8961164
A U.S. News & World report on swine flu deaths in pregnant women:
http://health.usnews.com/articles/health/healthday/2009/10/01/28-pregnant-women-have-died-from-swine-flu-cdc.html
A New York Times story on the use of anti-viral medicines (like Tamiflu) in pregnant women:
http://www.nytimes.com/2009/05/13/health/research/13flu.html
Does this information help? If you have more questions about swine flu and pregnancy, please add them in the comments box and we'll research them for you. And if you've had the H1N1 shot while pregnant, we'd love it if you'd write about how you decided to do it and whether you had any side effects.