Vaccine
PREGNANCY RECOMMENDATION: Compatible
BREASTFEEDING RECOMMENDATION: Compatible
PREGNANCY SUMMARY
Influenza vaccine is an inactivated virus vaccine (1). The vaccine is considered safe during all stages of pregnancy (2–7). However, the intranasal vaccine spray contains a live, attenuated virus and should not be used in pregnancy (1). Animal reproduction studies have not been conducted with the vaccine. If influenza vaccine is used in pregnancy, health care professionals are encouraged to call the toll-free number 877-311-8972 for information about patient enrollment in the Organization of Teratology Information Specialists (OTIS) study.
FETAL RISK SUMMARY
Neonatal passive immunization of short duration has been documented in some studies (4). The American College of Obstetricians and Gynecologists recommends that the vaccine be given to women who will be pregnant during the flu season (October–mid May) and to those at high risk for pulmonary complications regardless of trimester (1).
The CDC recommends the inactivated vaccine for women who will be pregnant during the influenza season (5). In addition, pregnant women who have medical conditions that increase their risk for complications from influenza should receive the vaccine (5).
A 2005 study used an electronic database to identify 252 pregnant women who had received influenza vaccine between 1998 and 2003 (8). Vaccination occurred at a mean gestational age of 26.1 weeks (range 4–39 weeks). There were no serious adverse events within 42 days of vaccination. Compared with controls who were not vaccinated, there were no differences between the groups in terms of pregnancy outcomes and infant medical conditions from birth to 6 months of age (8).
BREASTFEEDING SUMMARY
Maternal vaccination is compatible with breastfeeding and presents no risk to the nursing infant (5).
References
1.American College of Obstetricians and Gynecologists. Influenza vaccination during pregnancy. Committee Opinion. No. 468, October 2010. Obstet Gynecol 2010;116:1006–7.
2.Philit F, Cordier J-F. Therapeutic approaches of clinicians to influenza pandemic. Eur J Epidemiol 1994;10:491–2.
3.Bandy U. Influenza: prevention and control. R I Med 1994;77:393–4.
4.Linder N, Ohel G. In utero vaccination. Clin Perinatol 1994;21:663–74.
5.CDC. Guidelines for Vaccinating Pregnant Women. Available at http://www.cdc.gov/vaccines/pubs/preg-guide.htm. Accessed May 16, 2010.
6.Yeager DP, Toy EC, Baker B III. Influenza vaccination in pregnancy. Am J Perinatol 1999;16:283–6.
7.Kashyap S, Gruslin A. Influenza vaccination during pregnancy. Prim Care Update Ob/Gyns 2000;7:7–11.
8.Munoz FM, Greisinger AJ, Wehmanen OA, Mouzoon ME, Hoyle JC, Smith FA, Glezen WP. Safety of influenza vaccination during pregnancy. Am J Obstet Gynecol 2005;192:1098–106.