Medical Edge Newspaper Column

Flu shot a safe way for expectant mothers to stay healthy

September 26, 2008
Dear Mayo Clinic:
Is it safe to get a flu shot during pregnancy? Should I avoid vaccines in general until after my baby is born?

Answer:
The flu shot (influenza vaccine) is safe during pregnancy. The Centers for Disease Control and Prevention (CDC) recommends the flu shot for women who will be pregnant during influenza (flu) season. In North America, the peak flu season is usually November to March.

Protecting yourself from influenza during pregnancy is very important. Pregnancy can affect your immune system and put extra stress on your heart and lungs. As a result, you may be at increased risk of getting influenza. Serious complications from the flu, such as pneumonia, are more common during pregnancy. Pregnant women with influenza are far more likely to require hospitalization than are women with the flu who aren't pregnant.

Each year, influenza vaccines are developed against the strains of flu virus expected to be in circulation during the fall and winter of that year. It's not enough to have received the shot in a previous year. You need one this year, too!

The influenza vaccine is made from killed (inactivated) virus. It's considered safe during all stages of pregnancy and during breast feeding. If they have not already received it, women who give birth during the flu season should get the flu shot before leaving the hospital .If the mother is not immunized and she gets the flu, she could pass it along to her infant as well as to anyone else in the household who is not immunized.

Children who get influenza, especially before they are 5 years old, commonly need medical attention. Severe influenza complications are more frequent in children under 2 years of age. The CDC recommends that all children over six months of age be immunized for influenza.

Women should review and update their immunizations with their provider prior to becoming pregnant. Of course, that's not always possible. Once pregnant, women should stay current with all immunizations with one exception: pregnant women should avoid vaccinations made with live viruses. This includes the nasal-spray flu vaccine and the measles, mumps and rubella (MMR) vaccine.

If you are not up to date on your MMR immunization, make sure to get this prior to being discharged from hospital after delivery. In addition, check with your health care provider to make sure you are current with your tetanus, diphtheria and pertussis (Tdap) immunization and get this updated, if needed, at the same time.

It is important to stay protected against tetanus and diphtheria. Additionally, Tdap is protective against whooping cough (pertussis), a highly contagious respiratory tract infection. The number of whooping cough cases has increased in recent years, especially among children too young to have completed their full course of vaccinations. Most people recover from whooping cough without complications, but the illness is often more serious in children, especially in infants younger than 6 months of age.

If you are traveling outside the United States during your pregnancy, talk to your health care provider or to a physician who specializes in travel medicine about immunizations that you'll need.

One last point: if you are in a profession that requires annual testing for tuberculosis (TB) such as health care, don't avoid being tested while you are pregnant. The test is safe, and it's important to stay up to date on TB testing to protect your health, your baby's health, and the health of the people to whom you provide care.

In summary, talk with your provider about the all vaccinations and testing you need to have a healthy, safe pregnancy.

—Kristi L. Boldt, M.D., Obstetrics & Gynecology, Mayo Clinic, Rochester, Minn.