I know that many people, even healthcare professionals, make lame excuses about a maternal flu vaccine. We have heard everything from "the vaccine gives me the flu" to "I never get the flu" to "the flu isn't dangerous." These anti-vaccine beliefs betray the overwhelming facts about the safety and effectiveness of the flu vaccine, especially for pregnant mothers.
A new study published in a real high-quality biomedical journal supports the claims that the maternal flu vaccine protects the health of the mother, the developing fetus, and the newborn child. Let's take a look.
All about the flu
As we enter the 2019-20 flu season, the seasonal flu vaccine is still the best choice to prevent the flu. Overpriced supplements, luck, or pretending that the flu is not a dangerous disease are all based on ignorance, not science.
The flu can lead to hospitalizations or death. But there's more – this is what the CDC says about flu complications:
Most people who get influenza will recover in several days to less than two weeks, but some people will develop complications as a result of the flu. A wide range of complications can be caused by influenza virus infection of the upper respiratory tract (nasal passages, throat) and lower respiratory tract (lungs). While anyone can get sick with flu and become severely ill, some people are more likely to experience severe flu illness. Young children, adults aged 65 years and older, pregnant women, and people with certain chronic medical conditions are among those groups of people who are at high risk of serious flu complications, possibly requiring hospitalization and sometimes resulting in death. For example, people with chronic lung disease are at higher risk of developing severe pneumonia.
Sinus and ear infections are examples of moderate complications from flu, while pneumonia is a serious flu complication that can result from either influenza virus infection alone or from co-infection of flu virus and bacteria. Other possible serious complications triggered by flu can include inflammation of the heart (myocarditis), brain (encephalitis) or muscle (myositis, rhabdomyolysis) tissues, and multi-organ failure (for example, respiratory and kidney failure). Flu virus infection of the respiratory tract can trigger an extreme inflammatory response in the body and can lead to sepsis, the body’s life-threatening response to infection. Flu also can make chronic medical problems worse. For example, people with asthma may experience asthma attacks while they have the flu, and people with chronic heart disease may experience a worsening of this condition triggered by flu.
And one subtype of the flu, H1N1, is much more dangerous, attacking healthy young people more than those with other serious risk factors.
But the complications from the flu are what separate it from the cold. During the 2018-19 flu season, 129 American children died of the flu. Here are even more numbers:
- 37.4 - 42.9 million Americans contracted the flu
- 17.3 - 20.1 million of those had a medical visit because of the flu
- 531-647 thousand of those had to be hospitalized as an inpatient
- Finally, 36,400 - 61,200 died
- Worldwide, it is estimated that there will be approximately 290-650 thousand deaths.
That makes the flu one of the leading causes of death for humans, even more than HIV/AIDS in the USA. Think about that.
Maternal flu vaccine – the paper
In an article published in the Journal of Infectious Diseases, by Jemma L Walker, reported that when pregnant women received the flu vaccine, their future infants experienced a reduction in the number of flu cases and related hospitalizations prior to reaching 6 months of age. This is powerful evidence that the maternal flu vaccine is important for not only the mother and developing fetus but also for the newborn child.
The researchers examined data on infants in England from the Clinical Practice Research Datalink pregnancy register, matched on week-of-birth and region. It was adjusted for ethnicity
Here are some important results:
- The flu vaccine effectiveness (VE) was 66% during the 2013–2014 season and the VE against the dominant circulating influenza strain was higher at 78% against H1N1 in 2013–2014.
- The VE was 50% in 2014–2015, with similar VE against influenza-related hospitalization and 60% against H3N2 in 2014–2015.
- This study supported the results from another 2019 study that showed reductions in hospitalizations in a group of pregnant women who receive the maternal flu vaccine.
The authors concluded:
Young infants are at higher risk of complications from influenza compared to older children, and this results in appreciable healthcare utilization. Maternal vaccination is a valuable approach to protect infants (for whom seasonal influenza vaccine is not currently licensed) from influenza-related morbidity. Vaccine uptake in pregnant women in England has increased over time and was estimated to be 47.2% in 2017–2018, but this could be further improved. Our study adds to the growing evidence of the effectiveness of maternal influenza vaccination in preventing influenza and influenza hospitalizations in infants, and may help pregnant women to make informed decisions about vaccine receipt."
According to the CDC, the immune system, heart, and lungs of pregnant women and of women up to 2-weeks postpartum, make them more prone to severe illness from flu, including an illness resulting in hospitalization. Furthermore, the flu is also harmful to a pregnant woman’s developing baby. For example, one of the most common flu symptoms is a fever, which may be associated with neural tube defects and other adverse outcomes for a developing baby.
Summary
There is powerful evidence that the flu does significant harm to the pregnant mother, the developing fetus, and the newborn child. It is tragic that the uptake of the seasonal flu vaccine by pregnant mothers is so low.
The maternal flu vaccine could protect the mother and baby from this dangerous disease, but we continue to hear lame excuses from everyone about the vaccine.
This new study provides evidence that the flu vaccine saves lives.
Citations
- Thompson MG, Kwong JC, Regan AK, Katz MA, Drews SJ, Azziz-Baumgartner E, Klein NP, Chung H, Effler PV, Feldman BS, Simmonds K, Wyant BE, Dawood FS, Jackson ML, Fell DB, Levy A, Barda N, Svenson LW, Fink RV, Ball SW, Naleway A. Influenza Vaccine Effectiveness in Preventing Influenza-associated Hospitalizations During Pregnancy: A Multi-country Retrospective Test Negative Design Study, 2010-2016. Clin Infect Dis. 2019 Apr 24;68(9):1444-1453. doi: 10.1093/cid/ciy737. PubMed PMID: 30307490.
- Walker JL, Zhao H, Dabrera G, Andrews N, Thomas SL, Tsang C, Ellis J, Donati M, Pebody RG. Assessment of Effectiveness of Seasonal Influenza Vaccination During Pregnancy in Preventing Influenza Infection in Infants in England, 2013-2014 and 2014-2015. J Infect Dis. 2019 Nov 9;. doi: 10.1093/infdis/jiz310. [Epub ahead of print] PubMed PMID: 31711165.