Pregnancy and the Flu

I don't have much to say on the topic as I've never had a flu shot myself but I found some resources and articles that I thought are pertinent this year as they are about H1N1. I hope nobody here has to go through it!

CDC's take on the H1N1 vaccine during pregnancy

Article about H1N1 during pregnancy

I will caution that there are forms of the vaccine (seasonal and H1N1) that contain thimerosal so make sure you request one without if you choose to be vaccinated.

Edit:

Here is the link to Dr. Bob Sears' website where he lists the ingredients for each of the H1N1 vaccines along with his opinion of them:

The Vaccine Book: Four Swine Ful Vaccines Approved by FDA

Excerpt from the above link (I added the bolding):

"What about pregnant and/or nursing mothers?

This is a little scary. The flu shots are ALREADY recommended for pregnant and nursing moms, BUT (and this is a really huge but) the vaccine product inserts make it very clear that the regular flu vaccines have never been tested on pregnant or nursing women to determine if there is any harm to fetuses or young babies (with one exception – the ­­­­Flumist nasal spray brand did have some testing in this area, BUT not enough, as is stated in the product insert).

Despite this complete lack of research, it is recommended for these moms anyway. Anyone see a problem with that?

If you do get a flu shot, at least make sure it is mercury free (or at least only TRACE mercury)."

Thanks for the info.  Considering pregnancy is one of the "underlying risks" the WHO cautions us about that might increase the susceptibility or severity of H1N1, I will be getting the vaccine if I can. I know numerous people who had it already!

This was a really quick post I did because I was short on time. I'm going to try to get some more resources to add as the day goes on.

Personally, I'm not big on the idea of flu shots. My doctor (who is a family physician and sees my husband and my kids as well) always pushes us to get them. This year is a bit different, though. When my daughter was an infant, she wasn't in daycare. My grandmother watched her so she really wasn't out there and exposed. Now, however, she is in preschool, we have an infant/toddler and my grandmother watches him. I can't imagine what would happen if she caught it, passed it to my son who then gave it to my 85-year-old grandmother who has a history of pneumonia. Devastating.

While we will NOT be getting the H1N1 vaccine YET (due to the "newness" of the vaccine), we're strongly considering vaccinating against the seasonal flu this year. I'm just so torn on what to do. I know it's better if we build up a natural immunity to these types of disease but I know that it could be detrimental to my family. None of use have every had the flu, though. Which risk to take? I wish there were an instruction manual!

Sorry, that was a bit longer than I wanted it to be!

Neither of us have ever gotten flu shots prior to this year. But we are now pregnant for the first time and felt compelled to go ahead and get one. My wife is pretty sensitive to medications, so we were a little worried. But, she hasn't had any reaction at all and the peace of mind was worth it.

We are still cautious about the H1N1 vaccine, though. So far, there hasn't been an outbreak in our area. I know of 1 person who contracted it about a month ago and she said it wasn't any worse than any flu symptoms she had experienced in the past (and she is a fairly unhealthy person).

I'm hoping by the time it becomes available to us, there will be more information. As of right now, we are not planning on getting the H1N1 vaccine.

If your wife is pregnant she should ask her doctor specifically about it (and obviously do whatever he/she suggests). But I am thinking she should get the H1N1 vaccine if available as it is one of the underlying health conditions the WHO warns about (see the info I pasted below).

Bier, although I am a big believer in natural immunity as well for certain harmless things (my Dad used to not let us freak out if our food fell on the floor etc), but  you cannot build up a typical "natural immunity" to seasonal flu because the strains mutate every year - it's like a different disease every year. Also be aware the predominant strain of flu is now H1N1, so that is this year's "seasonal flu" (although of course there is still a vaccine for typical flu).

From the who.org website:

Vulnerable groups

An increased risk during pregnancy is now consistently well-documented across countries. This risk takes on added significance for a virus, like this one, that preferentially infects younger people.

Data continue to show that certain medical conditions increase the risk of severe and fatal illness. These include respiratory disease, notably asthma, cardiovascular disease, diabetes and immunosuppression.

When anticipating the impact of the pandemic as more people become infected, health officials need to be aware that many of these predisposing conditions have become much more widespread in recent decades, thus increasing the pool of vulnerable people.

Obesity, which is frequently present in severe and fatal cases, is now a global epidemic. WHO estimates that, worldwide, more than 230 million people suffer from asthma, and more than 220 million people have diabetes.

Moreover, conditions such as asthma and diabetes are not usually considered killer diseases, especially in children and young adults. Young deaths from such conditions, precipitated by infection with the H1N1 virus, can be another dimension of the pandemic’s impact.

I was just at my doctor on Monday, and we talked about the flu in some length.  My husband and I contracted Influenza A (H1N1 is a strain of Influenza A) the spring of 2007, and we were both out for about a week.  It was miserable.  The worst was the cough we got with it that didn't ease up for about 3 weeks.  It was the sickest I've ever been.

We are now TTC, and I was at the doctor just for a check up, and he recommended the regular flu shot especially if I'm TTC.  I asked him about the H1N1 too.  He was very concerned about it.  He was trained and works out of the Mayo Clinic in Rochester, MN and their biggest concern is the lack of testing that they've been able to do with the vaccine.  Also, the fact that the media seems to know "everything" about the H1N1 flu and vaccine, and the medical world is still working through it.  It's definitely something to think about, but he said as of right now, he's not recommending any pregnant women get the H1N1 shot because of lack of knowledge and testing.

It's a tough to decision to go for the H1N1/Novel A vaccine or not. While getting your own doctor's opinion is critical, it's a good idea to weigh that up against your own research and particular expertise about yourself and your kids.

Here are some links I've used to get educated on the topic as best as I can. Hope they may help others here.

New England Journal of Medicine on pregnancy and H1N1/Novel A: http://h1n1.nejm.org/?s=pregnancy+h1n1&x= 0&y=0

NEJM on risks of vaccine: http://h1n1.nejm.org/?s=h1n1+vaccine+risk& ;x=0&y=0

Crofsblog is often quoted in other sources -- he's the go-to guy (originally started with bird flu, so he provides data on both strains). Good place to find links to other sites on H1N1/Novel A: http://crofsblogs.typepad.com/h5n1

This one looks interesting (a link off of crofsblog) but I haven't really scoured it: http://www.readymoms.org/

Although it's not confirmed yet and disputed on Effect Measure (http://scienceblogs.com/effectmeasure/2009/09 /once_more_on_the_vaccine_quest.php), there may be some evidence that getting the seasonal flu vaccine actually increases the risk of contracting H1N1/Novel A (Swine Flu):http://www.ctv.ca/servlet/ArticleNews/story/C TVNews/20090924/flu_shot_090924/20090924?hub= Health

This is THE topic in our office because I'm pregnant (due in a week) and my coworker's wife is pregnant.  I was given the seasonal flu shot last week and I didn't fight it, even though I've never received a flu shot in my life, nor do I plan to have them again.   Flu activity is extremely high in Dallas and I felt it was important to get the added protection. Yes, most of the activity is H1N1, which I haven't been vaccinated against, but I honestly view this as something is better than nothing.

I won't be pregnant when the H1N1 vaccine becomes available, but I will be breastfeeding and antibodies will pass from me to my baby via the milk.  I haven't made a final decision on this vaccine, but I'm leaning towards doing it under the hope that it helps protect my child.  She can't be vaccinated, which in some ways is a relief because it's a hard decision to make.

There was a swine flu epidemic in the 70's and there is a lot of speculation in the medical field that this is why older people aren't as susceptible to it.  They have natural antibodies. 

I'll pass...

According to the CDC, there have been approximately 700 reported cases of H1N1 in pregnant women since April. Of these, 100 women have required admission to an intensive care unit and 28 have died. In other words, 1 out of every 25 pregnant women who contracted H1N1 died of it. By any standard, that is an appalling death rate. 

Whatever you ladies choose to do, make sure you are informed with facts.

What the CDC fails to mention is secondary infections from an original flu virus or patients with asthmatic history or other underlying health issues that were the cause of complications. Receiving an H1N1 shot would have been just as dangerous for many of these people as simply contracting it through daily contact. There is always a small percentage of complications and dropouts in the CDC studies (it varies by the class being studied). Usually, it's around 1% which doesn't sound like much, but they don't list the number of participants in the study or who conducted it. Funny, huh? There is a lot of money to be made in the field of pharmaceuticals and vaccines, both for the pharmaceutical companies as well as healthcare providers getting kick-backs for carrying certain products. I don't trust the CDC to be forthright with anything that makes them look incompetent.

I agree you should be informed before making a decision, not scared into it by selective information.

This site is decidedly conservative, but the articles' content is fact. The video is of CDC head being interviewed on CNN...

This article highlights the proven relationships to vaccine and asthma is children.

There are thousands of these articles and studies all over the world that fail to spark the interest of the CDC or WHO. I find THAT to be truly appalling.

All this concern for citizens to get vaccinated in a world where cigarettes are legal and the government profits by raising the cost and collecting a tax. We wonder why healthcare is so unaffordable...duh? Society is raised on unnatural foods, shot full of so many things before the age of 1 that it's insane, exposed to unhealthy surroundings such as first or secondhand smoke, unhealthful eating habits, lack of exercise... Asthma, obesity, diabetes, autism... are all on the rise. Link?, uh yeah. I can't be the only one here that agrees that there are obvious people profiting from the choices we make. 

This pie chart shows the deaths surrounding smoking...interesting that the government does little more than raise the price to counteract the problem. This is info from the CDC website. People just smoke non-name brand now. Trust me, I live in NY. The Indian reservations are thrilled with the increase. Not offensive, but absolutely fact. I could not find more current mortality charts for smoking through the CDC. Could it be they are embarrassed by their horrendous failure to address the issue? I could have missed it too I guess. LOL!

Original Post by shill:

What the CDC fails to mention is secondary infections from an original flu virus or patients with asthmatic history or other underlying health issues that were the cause of complications. Receiving an H1N1 shot would have been just as dangerous for many of these people as simply contracting it through daily contact.There is always a small percentage of complications and dropouts in the CDC studies (it varies by the class being studied). Usually, it's around 1% which doesn't sound like much, but they don't list the number of participants in the study or who conducted it. Funny, huh? There is a lot of money to be made in the field of pharmaceuticals and vaccines, both for the pharmaceutical companies as well as healthcare providers getting kick-backs for carrying certain products. I don't trust the CDC to be forthright with anything that makes them look incompetent.

I agree you should be informed before making a decision, not scared into it by selective information.

This site is decidedly conservative, but the articles' content is fact. The video is of CDC head being interviewed on CNN...

This article highlights the proven relationships to vaccine and asthma is children.

There are thousands of these articles and studies all over the world that fail to spark the interest of the CDC or WHO. I find THAT to be truly appalling.

 I think it's important to ask questions and weigh the pro's and cons with vaccinations.  However, your comments sound a bit skewed.  Being pregnant makes the immune status of pregnant women vulnerable to the virus.  More so then a normal person.  Pregnancy also compromises lung function(as most of us know from experience), which would make it difficult to ensure that momma and baby are getting enough oxygen. 

My boss has H1N1, and it took him out hard core.  Normally, the man is as sturdy as a rock.  If I were pregnant, personally, I would choose to receive the vaccine.  The risks of H1N1 outweigh the risks of the vaccine.  However, because I am not pregnant, I am still weighing my options. 

I'll start by questioning which part of my post is skewed. It's my opinion and also it's all fact.

I don't think we'll know the true effects of these vaccinations until another epidemic of genetic disorders surfaces. I think there's a cloudy track record for our CDC. This is more than documented. In 1976, the vaccine led to GBS after the country was sent into a panic by the CDC. I'm sure they stressed the importance of that shot then as well. Maybe you'll find these interesting. It's a list of factual occurrences highlighting the mistakes made over the years with vaccines. For those who rely on WebMd and other big name health websites, remember who governs those; the CDC. This is also a fact.

I'm not knocking the possibility the swine flu has to be severe, but I'm sure as hell questioning the methods of combating it.

Original Post by crazineko:

 If I were pregnant, personally, I would choose to receive the vaccine.  The risks of H1N1 outweigh the risks of the vaccine.

 The problem is that they don't know the risks of the vaccine on pregnant women because it hasn't been tested on pregnant women.

Original Post by bier:

Original Post by crazineko:

 If I were pregnant, personally, I would choose to receive the vaccine.  The risks of H1N1 outweigh the risks of the vaccine.

 The problem is that they don't know the risks of the vaccine on pregnant women because it hasn't been tested on pregnant women.

 The only thing that's new/different about this vaccine is the strain of virus that was used to make it. That happens every year with the seasonal flu vaccine.  Here is a quote from the CDC:

"We have cut no corners," said CDC director Thomas Frieden. "This flu vaccine is made as flu vaccine is made each year. By the same companies. In the same production facilities. With the same procedures. With the same safety, safeguards. We have had literally hundreds of millions of people vaccinated against flu with flu vaccine made in this way."

Original Post by crazineko:

Original Post by bier:

Original Post by crazineko:

 If I were pregnant, personally, I would choose to receive the vaccine.  The risks of H1N1 outweigh the risks of the vaccine.

 The problem is that they don't know the risks of the vaccine on pregnant women because it hasn't been tested on pregnant women.

 The only thing that's new/different about this vaccine is the strain of virus that was used to make it. That happens every year with the seasonal flu vaccine.  Here is a quote from the CDC:

"We have cut no corners," said CDC director Thomas Frieden. "This flu vaccine is made as flu vaccine is made each year. By the same companies. In the same production facilities. With the same procedures. With the same safety, safeguards. We have had literally hundreds of millions of people vaccinated against flu with flu vaccine made in this way."

 

 They haven't tested the REGULAR flu vaccine on pregnant women, either.

ETA: I just read the package insert for the Sanofi Pasteur brand of the H1N1 flu vaccine and here's what it says in regards to pregnant women (I added the bolding):

"Pregnancy Category C: Animal reproduction studies have not been conducted with Influenza A (H1N1) 2009 Monovalent Vaccine or Fluzone vaccine. It is also not known whether these vaccines can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Influenza A (H1N1) 2009 Monovalent Vaccine should be given to a pregnant woman only if clearly needed."

It's up to us and/or our doctors to decide if it is "clearly needed" in our individual circumstances.

Original Post by crazineko:

Original Post by bier:

Original Post by crazineko:

 If I were pregnant, personally, I would choose to receive the vaccine.  The risks of H1N1 outweigh the risks of the vaccine.

 The problem is that they don't know the risks of the vaccine on pregnant women because it hasn't been tested on pregnant women.

 The only thing that's new/different about this vaccine is the strain of virus that was used to make it. That happens every year with the seasonal flu vaccine.  Here is a quote from the CDC:

"We have cut no corners," said CDC director Thomas Frieden. "This flu vaccine is made as flu vaccine is made each year. By the same companies. In the same production facilities. With the same procedures. With the same safety, safeguards. We have had literally hundreds of millions of people vaccinated against flu with flu vaccine made in this way."

 

You just shot yourself in the foot on that one. You are correct that vaccine procedures have not changed. But Bier is correct that pregnant women were never part of clinical studies. The drug companies post all this in the fine print, but the CDC does not begin to be honest about potential harm or accuracy of the studies (if there even were any).The studies they claim to have conducted were verrrrry small focus groups according to drug manufacturers. Independent studies all over the world have used larger groups over longer periods of time, with more accurate documentation. These independent studies have yielded a wealth of contradiction in regards to the safety and potential to cause future health problems. These studies are also not backed by any organizations trying to "make a case".

If you'd like to continue getting all your information from the CDC, then I'll assume you also believe all the tabloid magazines as well. That is not even close to being informed. You're simply quoting the devil's tongue, for lack of a better term. Do you believe the government is honest?

Original Post by crazineko:

According to the CDC, there have been approximately 700 reported cases of H1N1 in pregnant women since April. Of these, 100 women have required admission to an intensive care unit and 28 have died. In other words, 1 out of every 25 pregnant women who contracted H1N1 died of it. By any standard, that is an appalling death rate. 

Whatever you ladies choose to do, make sure you are informed with facts.

 I agree. 

I've never gotten the flu shot before, and probably won't in the future. However, my Dr told me last week that I should definitely get the H1N1 shot. She said quite plainly "statistics show that pregnant women who get H1N1 die more often"...

There are two types of H1N1 vaccine, one that contains a booster (adjuvant) and one that does not. The unadjuvanted vaccine has been tested more on pregnant women compared to the vaccine that contains the booster.

H1N1 vaccine isn't available in Canada yet (very soon) but I will be getting it. My Dr didn't know how much of the unadjuvanted vaccine would be available but said if it wasn't available in my area to definitely get the adjuvant vaccine anyway--don't wait.