Last week I walked into the hospital and greeted my colleague, who was clearly agitated. He had just finished an urgent cesarean section that resulted in both baby and mom ending up in intensive care. Why? The flu. It’s only early fall, but the flu has arrived and started to claim its victims. As an obstetrician, I want my patients to have a safe delivery and a healthy baby. The flu shot during pregnancy is an important part of achieving that goal.
I sigh when I hear one of my pregnant patients say, “But I’ve never gotten the flu. I don’t need a shot.” I recall a patient I had to put on life support two years ago because the flu severely damaged her lungs. I also remember my patient I had to deliver early because of the flu and how she waited 10 days to meet her baby. I visited her in the intensive care unit as her distraught husband balanced the joy of the newborn, the fear of losing his wife, and the anxiety of doing this alone.
The flu is dangerous to pregnant women, so dangerous that they and children under the age of 5 are prioritized to get the flu shot. Pregnant women lose 30 percent of their lung capacity by 16 weeks. When your lungs lose that much volume, you can’t take the flu’s hit without risking serious consequences.
And the flu’s fever can threaten the developing baby’s life, as happened with my colleague’s patient last week: That baby’s heart rate went from 230 to zero beats in less than five minutes; baby needed chest compressions to revive its heart. Flu affects a fetus early, too; in the first trimester, fever can cause neural tube defects — birth defects of the brain, spine, or spinal cord.
The flu shot a pregnant woman receives protects her and her baby in two important ways. First, it can reduce the risk of getting the flu by as much as 60 percent. And if mom does get the flu, it can be milder. The shot also protects the newborn for those first 6 months when the baby is too young to get the flu shot.
The protection mom gets from the flu shot is transferred to the baby to help build up his or her ability to fight the illness. Then the Centers for Disease Control and Prevention (CDC) recommends flu vaccination for anyone over 6 months of age.
Multiple studies and years of evidence support the safety of flu vaccination in pregnant women. A pregnant woman can get a flu shot anytime during pregnancy, and flu season can last from October through May. No mom-to-be should skip her flu shot.
Knowing these facts, I was dismayed to read a recent controversial study questioning the safety of flu shots during the first trimester of pregnancy. The researchers studied only a small group of women (lessening confidence in accuracy), and this stand-alone research begs more scrutiny. One of the study’s coauthors even acknowledged the outcomes were unexpected and need more investigation.
My colleagues and I are not alone in our continued confidence about vaccinating pregnant women. Recently the American College of Obstetricians and Gynecologists (ACOG) and CDC voiced support for influenza vaccination during pregnancy. ACOG stated: “Influenza vaccination is an essential element of prenatal care,” citing flu’s “increased risk” for illness or death to pregnant women. ACOG reiterated the vaccine’s protection of newborns, too.
For me, flu vaccination during pregnancy is a given. The benefits far outweigh any potential risks. Influenza can kill, and pregnant women — and newborns — are high risk for the disease. Unless proven otherwise, my colleagues and I will continue adamantly to advise the flu vaccine’s protection to our patients. We’re heading into flu season; get vaccinated as soon as possible. If you have any concerns, be sure to talk with your doctor.
Kimberly Carter, M.D., M.P.P., is an obstetrician-gynecologist in Austin.