Vaccines during pregnancy and breastfeeding

From the Flu and Cold Health Center

Congratulations on your pregnancy! You're eating right, getting extra rest and taking your prenatal vitamins. After all, you want to do everything you can to ensure a healthy baby! But have you given any thought to protecting yourself and your baby against infectious diseases—like seasonal influenza and the H1N1 flu virus, an additional flu risk this year?

It's important to consider vaccination part of your prenatal care. That's why the U.S. Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) has specific recommendations for pregnant and breastfeeding women. The committee notes that there is no evidence of risk to your developing baby if you are vaccinated with an inactivated viral or bacterial vaccine while pregnant. In either case, the committee notes, the "benefits of vaccinating pregnant women usually outweigh the potential risks when the likelihood of disease exposure is high, when infection would pose a risk to the mother or fetus, and when the vaccine is unlikely to cause harm."

The CDC's ACIP recommends both the seasonal flu vaccination and the H1N1 vaccine for pregnant and breastfeeding women and for people 6 months to 24 years.

The CDC also identifies four safe and effective optional vaccines for pregnant women, if you have been or could be exposed to any of the following bacterial and viral diseases: Hepatitis B, tetanus-diphtheria, meningococcal and rabies.

So what makes the flu vaccines so important? Well, you're much more likely to be exposed to influenza in any given year than meningitis or rabies. Plus, pregnancy-related changes in your immune and respiratory systems mean that you are at higher risk for flu-related complications. In fact, if you get the flu while you're pregnant, you're more likely to be hospitalized with complications. Another good reason to get vaccinated against the flu is that a recent study found that your vaccine could protect your baby during his or her first six months—when infants can't receive a flu vaccine, yet when they are very vulnerable to flu-related complications.

This year, the novel H1N1 flu ("swine flu") poses an additional risk. At this point, scientists expect illnesses from H1N1 flu to continue for some time, so it's important for people—especially pregnant women or parents of infants and young children—to be as informed about the virus as possible.

Make Flu Vaccines a Family Affair

You're not the only one who needs a vaccine. The people around you should also get flu vaccines this season. That reduces the risk that they'll catch the flu and bring it home to you or your newborn.

Not one but two vaccines are recommended this year: One for seasonal flu and one for H1N1 flu.

There are also two forms of seasonal flu vaccine: the inactivated virus vaccine, delivered as an injection; and the attenuated virus vaccine, delivered as a nasal spray. Pregnant women should only receive the inactivated, injection form. The nasal spray vaccine is approved only for use in healthy people 2 to 49 years of age who are not pregnant.

One other thing: If you're severely allergic to eggs (the vaccine is grown in eggs), had a severe reaction to a flu vaccine in the past or are under six months of age, you should not be immunized. Also, if you have a fever, wait until you're better before getting the vaccine.

You have another consideration when it comes to the vaccine: thimerosal or thimerosal free? Thimerosal is a mercury compound that has been used for more than 80 years to preserve vaccines. Numerous studies find no harmful effects from the preservative in children or adults. Still, some people worry about it, which is why manufacturers have now made a thimerosal-free vaccine available. Ask your healthcare provider about your options.

Here's something else you should be aware of: Flu vaccines are not foolproof. It will not provide 100 percent protection against the flu. When the seasonal flu vaccine and the circulating viruses are similar, the vaccine can prevent the flu among 70 to 90 percent of healthy adults under 65.

Even if you do get the flu, the vaccine can still protect you against flu-related complications by minimizing the severity of the illness.

And, contrary to flu myths, you cannot get the flu from a flu shot or the nasal vaccine. If you get sick after a vaccine, it's just coincidence. In fact, the most common side effect of the shot is a little soreness at the injection site, and the most common side effect of the spray is a runny nose or nasal congestion.

Now's the Time

The best time for a flu shot is between September and December, before flu season really peaks in January, February or later. It usually only takes about two weeks for your body to make antibodies (immune system proteins that help your system recognize the flu virus) to the virus. So even if you get vaccinated after December, you still get some protection.

While a single vaccine lasts the entire season, it won't protect you next winter because your immunity fades. Plus, flu viruses change from year to year. That's why it's important to get vaccinated every year.

Guidelines for High-Risk Groups

Pregnant women and children are considered high risk for both seasonal flu and the H1N1 flu virus and potential related complications. That's why vaccinations for these groups are such an important consideration and are highly recommended by federal government and health professional groups, such as the American College of Obstetricians and Gynecologists.

For information on other high-risk populations, visit the CDC's flu information Web site: http://www.flu.gov/

Remember, if you are a new mom breastfeeding your baby, you should get vaccinated against both seasonal and H1N1 influenza. If you have already delivered your baby, you're eligible for the nasal, or "attenuated," version of the vaccines. In fact, you can have any type of vaccine—except the smallpox vaccine—while breastfeeding with no worries about it negatively affecting your baby in any way.

So what are you waiting for? Pick up the phone and make an appointment for your seasonal flu and H1N1 flu vaccines. Your health and your baby's health depend on you!

For more on protecting yourself from the flu during pregnancy, visit: www.healthywomen.org/flufree