H1N1 Guidance For Pregnant Women

Ruzanna Harutyunyan's picture

For pregnant women, the 2009 influenza A (H1N1) virus has presented some serious complications, both for mothers and their unborn babies. In comparison to the general population, a greater proportion of pregnant women infected with this virus have been hospitalized. Dr. James Phillips, MD., Branch Chief, Infectious Disease at the Arkansas Department of Health urges women who are pregnant to discuss with their doctors the details of appropriate treatment in the event the signs of the flu appear.

"We are suggesting that women discuss this issue with their doctors in advance so that they can be prepared to respond quickly in case they become infected with this new virus," Phillips said.

Severe illness and death has occurred in pregnant women who have contracted this flu since it appeared in late April of this year. Six percent of confirmed fatal 2009 H1N1 flu cases thus far have been in pregnant women while only about 1% of the general population is pregnant.

While hand washing, staying away from ill people, and other steps can help to protect pregnant women from influenza, vaccination is the single best way to protect against the flu. It is important for a pregnant woman to receive vaccine for this new flu as well as a seasonal influenza vaccine.

There are two type of flu vaccine. Pregnant women should get the "flu shot"— an inactivated vaccine (containing fragments of killed influenza virus) that is given with a needle, usually in the arm. The flu shot is approved for use in pregnant women.


The other type of flu vaccine — nasal-spray flu vaccine (sometimes called LAIV for "live attenuated influenza vaccine)—is not currently approved for use in pregnant women. This vaccine is made with live, weakened flu viruses that do not cause the flu). LAIV (FluMist®) is approved for use in healthy people 2-49 years of age who are not pregnant.

It is anticipated that seasonal flu and 2009 H1N1 vaccines may be administered on the same day but given at different sites (e.g. one shot in the left arm and the other shot in the right arm). However, we expect the seasonal vaccine to be available earlier than the 2009 H1N1 influenza vaccine. The usual seasonal influenza viruses are still expected to cause illness this fall and winter. Pregnant women and others at increased risk of complications of influenza are encouraged to get their seasonal flu vaccine once more data is available.

Some people, including pregnant women, may need two doses for full protection from the 2009 H1N1 Flu. We will know more about the number of doses once data from the clinical trials are available.

The side effects from 2009 H1N1 influenza vaccine are expected to be similar to those from seasonal flu vaccines. The most common side effects following vaccination are expected to be mild, such as soreness, redness, tenderness or swelling where the shot was given. If these problems occur, they usually begin soon after the shot and may last as long as 1-2 days. Like any medicines, vaccines can cause serious problems like severe allergic reactions. However life-threatening allergic reactions to vaccines are very rare.

The potential benefits of influenza vaccination in preventing serious illness, hospitalization, and death substantially outweigh these estimates of risk.

Anyone who has a severe (life-threatening) allergy to eggs or to any other substance in the vaccine should not get the vaccine. People should always inform their immunization provider if they have any severe allergies, if they've ever had a severe allergic reaction following flu vaccination.