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H1N1 vaccination priority in pregnancy

Jenny Decker RN's picture
Pregnancy and flu vaccination

On July 13, 2009, the Strategic Advisory Group of Experts (SAGE) on immunizations for the World Health Organization met in Geneva to make recommendations on who would receive priority swine flu vaccination. Among those at the top were pregnant women. Pregnant women comprised 6 % of American deaths from swine flu. The first American to die of swine flu was a pregnant woman from Texas. Although this woman had some underlying health conditions, the majority of the pregnant women who died were healthy when they were infected with the virus. This makes pregnancy a risk for swine flu that should not be ignored.

Complications of swine flu in pregnancy may include early labor or severe pneumonia. However, it is not known for sure if there is a higher susceptibility to the virus when pregnant. It is also unknown what the H1N1 virus does to the unborn child.

The CDC has cautioned pregnant women to be very alert to their bodies for symptoms of swine flu. These symptoms include fever, cough, sore throat, body aches, headaches, chills and fatigue, and diarrhea and vomiting. What should a woman do if she has these symptoms? Call the doctor right away. Other actions should be to stay at home and limit contact with others. The swine flu can make other health conditions worse (so can the seasonal flu), so the physician may choose to test for the H1N1 virus and treat with antivirals, like Tamiflu. It is also important that the pregnant woman who has had contact with anyone that has the swine flu call her doctor. Preventive treatment may be indicated.

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In a press briefing on July 24th, Anne Schubach from the CDC stated that the H1N1 virus can cause a whole spectrum of illness, meaning it can be very mild or it can be very severe. It is important to be mindful of this when pregnant, especially considering that pregnant women have died at a higher rate than the others from H1N1. Anne Schubach also stated that the best way to protect against the flu is vaccination for both the seasonal flu and the swine flu.

Even though the World Health Organization has made recommendations of who should receive priority immunization for the swine flu, the CDC will not be making those recommendations for the United States until July 29th. Pregnant women were at the top of WHO’s list.

Other ways to keep healthy include frequent handwashing, and covering the nose and mouth when coughing or sneezing. Avoid touching the eyes, nose, and mouth as these are excellent mediums for the spread of germs. Last of all, stay at home if sick. Antivirals in pregnancy may be used to either prevent or treat H1N1. These are considered to be safe during pregnancy, although there is still relatively little research about this information.

Pregnant women should be informed as to when they need emergency care. This is a list of symptoms that the woman and those around her should be aware of: difficulty breathing or shortness of breath, pain or pressure in the chest or abdomen, sudden dizziness, confusion, severe and/or persistent vomiting, decreased or no movement of the baby, and a high fever that is not responding to Tylenol. These symptoms warrant immediate emergency medical attention.

Centers for Disease Control
World Health Organization