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The H1N1 Flu Vaccine in Pregnancy
Pregnant women have higher rates of hospitalization and death from H1N1 influenza than the general U.S. population, and are advised to obtain the flu vaccine during pregnancy. The flu vaccine reduces the chance of illness in expectant mothers and in their infants. A recent study showed that the seasonal flu vaccine given during pregnancy reduced the chances of flu illness in infants by 63%. Because the vaccine can be protective for both mothers and their infants, the Advisory Committee on Immunization Practices (ACIP) recommends that pregnant women get the seasonal flu vaccine as well as the 2009 H1N1 monovalent vaccine.

Where should I get the vaccine? You should ask your health care provider for information on where to obtain the vaccine. You may be able to get the vaccine from your obstetric provider, a primary health clinic, a local hospital or a birthing center. You only need to receive one dose of the H1N1 vaccine, and you should also obtain one dose of the seasonal flu vaccine. Both of these can be obtained on the same day.

What if my baby delivers before I receive the vaccine? Your health can have effect the health of your infant. Infants must be six months or older to receive the flu vaccine, and will benefit from having healthy caretakers. Anyone living with or caring for a young infant should receive the seasonal flu vaccine as well as the 2009 H1N1 vaccine.

What about breastfeeding moms? New mothers who are breastfeeding can obtain the seasonal flu vaccine as well as the 2009 H1N1 vaccine. Breastfeeding babies may receive protective antibodies from mothers who have the vaccine; this will reduce their chances of getting sick with the flu.

What form of vaccine should I have – injectable or nasal? If you are pregnant, you should only receive the injectable form of the influenza vaccine, which contains inactivated (killed) virus. The nasal spray vaccine contains weakened virus, and is not licensed for use in pregnant women.

If you are post-partum and/or nursing, you can receive either the injectable vaccine or the nasal spray form. Both are safe.

Does H1N1 monovalent flu vaccine contain preservatives? The multi-dose vials of the flu vaccine contains thimerosal, a preservative containing mercury. This has not been shown to be harmful during pregnancy. However, pregnancy women who prefer to avoid exposure to vaccine preservatives can request preservative-free seasonal or monovalent flu vaccines which are available in single-dose syringes.

Will I have any side effects? Pregnant women may have the similar side effects from flu vaccines as non-pregnant women. The most common side effects include mild soreness, redness, tenderness or swelling at the site of the injection. Some women experience headache, muscle aches, fever, fatigue and nausea which might begin soon after the injection and could last for 1 – 2 days. Some women who are prone to fainting from injections could experience a similar reaction to the flu shot. And, although severe allergic reactions are rare, any woman with a history of severe (life-threatening) allergy to eggs or other substances found in vaccines should NOT get the vaccine.

For additional information and updates, you can check the cdc website:

http://www.cdc.gov/h1n1flu/pregnancy/

Laura E. Stachel M.D. Obstetrician & Gynecologist