Are you getting a flu shot?

[jean]

Are you getting a flu shot, and if so, when?
I'm leaning toward yes, because I don't want to get the flu and confuse it with HELLP symptoms. I'm just not sure how late to get it..I don't want the benefit of it to run out before the flu season is over. (And yet I don't want to wait too long because who knows when I'll end up delivering!)

[cmccaffrey]

There are two shots I feel as though I should get, the flu shot and the whooping cough vaccine. I don't know when would be a good time for either of those. I have no advice though... Hopefully someone else will chime in.

[angieb]

I decided not to last year for several reasons (much to my mfm's annoyance but my ob never said a peep about it). One, they change it every year and never test it in pregnant women, which made me very uncomfortable. Two, I read a Cochrane Review article questioning the safety and effectiveness of the flu shot (I can't find the same one that was from last year, but here's a link to an older one with similar information http://www.medicalnewstoday.com/releases/55507.php ). Three, I wasn't working( (but also did not get it/was not going to get it in my first pregnancy when I was teaching middle schoolers, and that was with the H1N1 hysteria in full swing). And I was not due near flu season- April/May (but also was not going to get it when I was due in January.) If you do get it, make sure you get the thimersol free version. Definitely don't get it in the first trimester. But besides that, if you are going to get it, you can pretty much get it whenever.

As for the Dtap/Tdap (whooping cough), they usually like you to get it before pregnancy, but if you haven't had it in the last 2 years, they will usually give it to you in the hospital. I made DH get it before the baby was born and also made my parents get it. (Well, I didn't really "make" them get it, but I told them if they didn't, they weren't going to be holding my newborn.)

I'm not really a big vax fan, we are vaxing Lucas on a delayed schedule (only 2 shots at a time per visit/month instead of the 6 or so they are supposed to get, and some vax that are not necessary for newborns, like the Hep.B they give them at birth, we are delaying indefinitely as I am certain that I do not have Hep.B -they test you in your prenatal bloodwork- and I'm certain my newborn/infant is not sharing needles or getting a tattoo or at risk to contract Hep.B. They give it at birth to "catch" the babies from mom's with Hep.B that do not know it, but for many babies, the Hep.B is not necessary until much later.)

[jean]

Wow, are there any more articles (maybe more recent?) out there that talk about the flu shot? (esp in pg women?)

[steffthomas]

I'm only a few weeks away from delivery so I probably won't end up getting one until after baby is born--then after that who knows. The only reason I'm delaying is because I'm exhausted lol and am really not going out beyond necessary trips. I am just so darn tired.

I understand that these vaccines do come out yearly and are not necessarily tested on pregnant women--however the benefits of the vaccine out weigh the risks. The TRUE flu (not just the puking, stomach ache "flu", but the real you've been swabbed for it and you have influenza whatever) can actually be quite risky. Although it doesn't seem from what I've read to necessarily be worse for pregnant women--very young and very old (esp. very elderly) have a higher morbidity rate. BUT it's all up to you and what you feel comfortable with.

[steffthomas]

Oh and as for the hepatitis B vaccine--I understand your concerns there but 20-30% of the people who do have Hepatitis B (which if I remember correctly is somewhere just over a million people in the US alone), contracted it as a child--and those who didn't contract it at birth contracted it while in close contact with someone who was already infected. Not trying to tell you what to do at all-just wanted to pass that a long!

[angieb]

-I understand your concerns there but 20-30% of the people who do have Hepatitis B (which if I remember correctly is somewhere just over a million people in the US alone), contracted it as a child--and those who didn't contract it at birth contracted it while in close contact with someone who was already infected.

Do you have any research to support this? Not trying to debate you, I'm genuinely curious for more information since it is transmitted through blood, semen, vaginal fluids, mainly, that number seems crazy. Maybe the 20-30% of the people who have Hep.B who contracted it as children were kids of heroin addicts/etc?

[angieb]

Wow, are there any more articles (maybe more recent?) out there that talk about the flu shot? (esp in pg women?)

Here's a Cochrane Review from July 2010, they don't mention pregnancy, but they do question the effectiveness of the vaccine in adults.

Over 200 viruses cause influenza and influenza-like illness which produce the same symptoms (fever, headache, aches and pains, cough and runny noses). Without laboratory tests, doctors cannot tell the two illnesses apart. Both last for days and rarely lead to death or serious illness. At best, vaccines might be effective against only influenza A and B, which represent about 10% of all circulating viruses. Each year, the World Health Organization recommends which viral strains should be included in vaccinations for the forthcoming season.

Authors of this review assessed all trials that compared vaccinated people with unvaccinated people. The combined results of these trials showed that under ideal conditions (vaccine completely matching circulating viral configuration) 33 healthy adults need to be vaccinated to avoid one set of influenza symptoms. In average conditions (partially matching vaccine) 100 people need to be vaccinated to avoid one set of influenza symptoms. Vaccine use did not affect the number of people hospitalised or working days lost but caused one case of Guillian-Barré syndrome (a major neurological condition leading to paralysis) for every one million vaccinations. Fifteen of the 36 trials were funded by vaccine companies and four had no funding declaration. Our results may be an optimistic estimate because company-sponsored influenza vaccines trials tend to produce results favorable to their products and some of the evidence comes from trials carried out in ideal viral circulation and matching conditions and because the harms evidence base is limited..

They also note that of all of the studies they analyzed, nearly half of them were funded by the drug manufacturers who stand to gain a profit from the vaccines.
Here's more about the funding and drug company bias...

WARNING:
This review includes 15 out of 36 trials funded by industry (four had no funding declaration). An earlier systematic review of 274 influenza vaccine studies published up to 2007 found industry funded studies were published in more prestigious journals and cited more than other studies independently from methodological quality and size. Studies funded from public sources were significantly less likely to report conclusions favorable to the vaccines. The review showed that reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies. The content and conclusions of this review should be interpreted in light of this finding.

http://onlinelibrary.wiley.com/doi/10.1 ... 4/abstract

And here's one from 2008 on the effectiveness of the flu shot for children...http://onlinelibrary.wiley.com/doi/10.1 ... 3/abstract

[aajatwins]

I don't have a medical background and I rarely follow research, so this is just my opinion.
I have asthma and have gotten a flu shot every year since I was little. I've only gotten the flu a handful of times, but when I get sick it affects everything for me with the asthma. My kids also have respiratory weakness - one definitely has allergy-induced asthma like me - so they will struggle the same way with any illness making breathing harder. So we get flu shots. I got mine last week at the OB and my kids are getting them tomorrow. I'll make my hubby get one again this year because I will have this baby sometime in the next 4 weeks. We actually usually wait until October and that seems to cover the season better.

I was thinking I got the whooping cough vaccine just after I got pregnant, but it might have been before.

[caryn]

The PF's Medical Board has strongly advised that pregnant women get the flu shot in the past, and as I understand it this still holds. The mortality rate from H1N1 was *much higher* in pregnant women than in the regular population, and most of the MFMs who advise us were also caring for pregnant women on ventilators because they'd caught the flu.

See http://www.preeclampsia.org/component/l ... flu-season

The Preeclampsia Foundation Medical Board encouraged all pregnant women to strongly consider the non-live version of the H1N1 vaccine, as the risk of the vaccine is far lower than the risk to those who do not receive it. The protection of the vaccine also extends to the baby after birth. As with preeclampsia, the key for improving health outcomes and decreasing mortality is to recognize the signs and symptoms and receive proper medical treatment immediately.

Our Medical Board has requested that we post this warning to protect you. This applies to all pregnant women, regardless of whether or not you may have or get preeclampsia.

Jean, this says the sooner in the season that you get the vax, the better: http://www.ncbi.nlm.nih.gov/pubmed/21640230

Most of the benefit for infants was limited to those whose mothers were vaccinated within the first 4 weeks of vaccine availability. Once all women who were pregnant at the time of vaccine availability were vaccinated, vaccination of newly pregnant women had benefits for mothers but not infants. Delay of vaccination beyond November reduced both effectiveness and cost-effectiveness.

The ACOG recommends pregnant women be vaccinated for flu as early as possible in the season: http://www.ncbi.nlm.nih.gov/pubmed/20859176

No study to date has shown an adverse consequence of inactivated influenza vaccine in pregnant women or their offspring. Vaccination early in the season and regardless of gestational age is optimal, but unvaccinated pregnant women should be immunized at any time during influenza season as long as the vaccine supply lasts.