Tag Archives: pregnancy

Pregnancy and H1N1 vaccination

The question of vaccination for Influenza (H1N1) in pregnancy is frequently asked. A small study published by NIH does provide some answers around this.

Why all the concern about pregnancy?
To date there have been 100 pregnant women hospitalized with H1N1 in the US this season. 28 deaths have occurred in this group. This is an alarmingly high proportion for this healthy group (28% of admissions!). Though the total numbers seem very small it is the proportion of deaths in this important group that is high. Why is this group more important than other? To say the obvious; too many other lives depend on these women. A pregnant women is likely to have other children at home, those children are not only at risk for illness from mother but if mother is incapacitated or worse dies can changes the social structure of the home and future lives of her young children. Loss of life in other groups of people as traumatic as it may be does not carry as great a social burden as losses in this group can. This group is therefore at highest priority to be vaccinated.

Do pregnant women have adequate response to vaccination?
The study does show that pregnant women do mount an adequate response to a single dose of inactivated injectable vaccine and it is well tolerated. The 15mcgm dose appears to provide adequate response in 92% of recipients and 30mcgm in 96% of recipients. the pool sizes were very small at 25 women in each group.

The H1N1 2009 vaccine is made in an identical process to the existing seasonal influenza vaccine. It is a killed vaccine, therefore cannot cause H1N1. It is also thiomersal free.

Pregnancy and antiviral treatment

Pregnant women are at higher risk of hospitalization and death from influenza.
Though Oseltamivir is category C due to lack of trials in this group, it has been used successfully in all stages of pregnancy.
All pregnant women with influenza like illness (ILI) should be started on oseltamivir as early as possible.
Do not wait for lab confirmation before initiating treatment.
If pregnant women is exposed to known case of influenza a 10 day course of oseltamivir may be indicated as prophylaxis.
Prevention with vaccination with inactivated injectable vaccine is indicated in all pregnant women.
CDC reference for details