• Obstetric Care Professionals Urge: The Time for Influenza Vaccination is Now

    Flu season is here, and many parts of the country are already seeing unprecedented levels of influenza-like illness and confirmed influenza infection. That is why, collectively, the American Academy of Family Physicians; American College of Nurse-Midwives; American College of Obstetricians and Gynecologists; Association of Women’s Health, Obstetric and Neonatal Nurses; National Association of Nurse Practitioners in Women’s Health, and the Society for Maternal-Fetal Medicine are urging health care professionals to strongly recommend flu vaccination for all patients—especially those who are pregnant—and offer vaccination in your office whenever possible.

    Flu activity is surging at alarming rates.

    • Data from the Centers for Disease Control and Prevention indicate that flu-related hospitalizations are the highest they have been in over 10 years.
    • At the time of this Call to Action, there have already been five pediatric deaths this season (1).
    • Data indicate fewer people are getting vaccinated. In pregnant people alone, there has been an 8% decrease in vaccination since the 2019–2020 flu season (2).

    Pregnant individuals are at increased risk of severe illness and poor outcomes related to influenza infection.

    • Flu can be an especially serious disease for this population because of the increased risk of fetal demise (3), preterm labor, and preterm birth (4,5).
    • Influenza can also cause severe, life-threatening illness in pregnant individuals themselves (6, 7).

    Influenza vaccination plays a critical role in protecting pregnant individuals against serious illness and potentially devastating outcomes.

    • Influenza vaccination helps prevent severe illness and hospitalization in pregnant people who get the flu.
    • Influenza vaccination during pregnancy transfers antibodies to the fetus, helping to protect infants after birth against the flu before they become eligible for vaccination at 6 months (8).
    • Flu vaccines have an excellent safety profile and have been safely administered to millions of pregnant and lactating people.
    • Data from the Southern Hemisphere indicate that this year’s vaccine effectively reduced the risk of hospitalization from A(H3N2)—the predominantly circulating influenza strain—by nearly 50% (9).

    A strong recommendation from a trusted health care professional can be the deciding factor in a person’s choice to get vaccinated.

    • Even if a patient has already declined vaccination, this season’s increased flu activity may have changed their opinion about getting vaccinated.
    • Flu vaccine should be given as soon as possible in pregnancy; there is no need to wait for a specific trimester to get vaccinated.

    Be a champion for vaccination this year and every year, and encourage your staff, coworkers, and patients to receive a flu vaccine to protect themselves and others.

    For more information and resources, see the Maternal Immunization Task Force Resource Page.

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    References

    1. Centers for Disease Control and Prevention. Weekly U.S. influenza surveillance report. CDC; 2022. Accessed November 18, 2022. https://www.cdc.gov/flu/weekly/index.htm
    2. Centers for Disease Control and Prevention. Flu, Tdap, and COVID-19 vaccination coverage among pregnant women – United States, April 2022. CDC; 2022. Accessed November 18, 2022. https://www.cdc.gov/flu/fluvaxview/pregnant-women-apr2022.htm
    3. Håberg SE, Trogstad L, Gunnes N, Wilcox AJ, Gjessing HK, Samuelsen SO, et al. Risk of fetal death after pandemic influenza virus infection or vaccination. N Engl J Med 2013;368:333-40. DOI: 10.1056/NEJMoa1207210 https://www.nejm.org/doi/10.1056/NEJMoa1207210
    4. Richards JL, Hansen C, Bredfeldt C, Bednarczyk RA, Steinhoff MC, Adjaye-Gbewonyo D, et al. Neonatal outcomes after antenatal influenza immunization during the 2009 H1N1 influenza pandemic: impact on preterm birth, birth weight, and small for gestational age birth. Clin Infect Dis 2013;56:1216-22. DOI: 10.1093/cid/cit045 https://academic.oup.com/cid/article/56/9/1216/294242
    5. Pierce M, Kurinczuk JJ, Spark P, Brocklehurst P, Knight M. Perinatal outcomes after maternal 2009/H1N1 infection: national cohort study. UKOSS. BMJ 2011;342:d3214. DOI: 10.1136/bmj.d3214 https://www.bmj.com/content/342/bmj.d3214.long
    6. Oluyomi-Obi T, Avery L, Schneider C, Kumar A, Lapinsky S, Menticoglou S, et al. Perinatal and maternal outcomes in critically ill obstetrics patients with pandemic H1N1 Influenza A. J Obstet Gynaecol Can 2010;32:443-7. DOI: 10.1016/S1701-2163(16)34497-8 https://www.sciencedirect.com/science/article/abs/pii/S1701216316344978
    7. Jamieson DJ, Honein MA, Rasmussen SA, Williams JL, Swerdlow DL, Biggerstaff MS, et al. H1N1 2009 influenza virus infection during pregnancy in the USA. Novel Influenza A (H1N1) Pregnancy Working Group. Lancet 2009;374:451-8. DOI: 10.1016/S0140-6736(09)61304-0 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)61304-0/fulltext
    8. Nunes MC, Madhi SA. Prevention of influenza-related illness in young infants by maternal vaccination during pregnancy. F1000Res 2018;7:122. DOI: 10.12688/f1000research.12473.1https://f1000research.com/articles/7-122/v1
    9. Olivares Barraza MF, Fasce RA, Nogareda F, Marcenac P, Vergara Mallegas N, Bustos Alister P, et al. Influenza incidence and vaccine effectiveness during the southern hemisphere influenza season - Chile, 2022. MMWR Morb Mortal Wkly Rep 2022;71:1353-8. DOI: 10.15585/mmwr.mm7143a1 https://www.cdc.gov/mmwr/volumes/71/wr/mm7143a1.htm

    This publication was supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $500,000 with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.

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    About American Academy of Family Physicians
    Founded in 1947, the AAFP represents 127,600 physicians and medical students nationwide. It is the largest medical society devoted solely to primary care. Family physicians conduct approximately one in five office visits -- that’s 192 million visits annually or 48 percent more than the next most visited medical specialty. Today, family physicians provide more care for America’s underserved and rural populations than any other medical specialty. Family medicine’s cornerstone is an ongoing, personal patient-physician relationship focused on integrated care. To learn more about the specialty of family medicine and the AAFP's positions on issues and clinical care, visit www.aafp.org. For information about health care, health conditions and wellness, please visit the AAFP’s consumer website, www.familydoctor.org.