With flu season looming, the AAFP and other health care organizations once again are urging their members to immunize their pregnant and postpartum patients against influenza.
In a letter released Sept. 15, officers from the AAFP, the AMA, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American Pharmacists Association, the Association of Women's Health, Obstetric and Neonatal Nurses, and the American College of Nurse-Midwives joined the CDC and the March of Dimes in emphasizing the need for these women -- who are at increased risk for complications(www.cdc.gov) from influenza -- to be immunized.
"Please encourage your pregnant and postpartum patients to get vaccinated against influenza," says the letter. "If you do not offer influenza vaccination, please find out who offers the vaccine in your community and send your pregnant and postpartum patients there. You play a crucial role in helping to prevent influenza in your patients and their infants, which can save their lives."
The CDC's Advisory Committee on Immunization Practices, or ACIP, and the AAFP have recommended(4 page PDF) since 2004 that all women who are pregnant -- and those who may become pregnant -- during influenza season should be vaccinated.
However, vaccination rates for this high-risk group remain low. According to the CDC, less than one-fourth of pregnant women in the United States were vaccinated against seasonal influenza during the 2007-08 flu season. In fact, pregnant women have the lowest rates of coverage(www.sciencedirect.com) among all adult populations recommended to receive influenza vaccination.
In their letter to health care professionals, the AAFP and the other organizations said pregnant women should receive the influenza vaccine for a number of reasons.
- Changes in the immune system, heart and lungs during pregnancy make pregnant women more prone to severe illness from influenza compared with women who are not pregnant.
- Influenza increases the risk of premature labor and delivery.
- Vaccination during pregnancy has been shown to protect both the mother and her infant (up to 6 months of age) from the flu. Influenza hospitalization rates in infants younger than 6 months are more than 10 times that of older children.
- Pregnant women represented 5 percent of deaths from the 2009 novel influenza A (H1N1) in the United States, although only 1 percent of the overall population was pregnant during the pandemic. Severe illness in postpartum women also was documented. The 2009 H1N1 virus, which is included in the 2010-11 trivalent seasonal influenza vaccine, is expected to continue to circulate this season.
The letter also highlights the following safety information:
- flu vaccines have been given to millions of pregnant women during the past decade and have not been shown to cause harm to women or their infants;
- flu vaccine can be given to pregnant women during any trimester; and
- although pregnant women should receive the inactivated vaccine as an injection and not the live attenuated vaccine in spray form, postpartum women can receive either form of the vaccine, even if they are breastfeeding.