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In some medical circles, pregnancy is regarded as a "condition", one that places the pregnant woman at risk for contracting diseases and developing other conditions that could endanger the pregnant woman and the unborn baby in danger. This is because the woman's immune system is modified during the pregnancy so that the developing fetus is not rejected for being a "foreign" tissue within the body. It is also this reason that makes some vaccines are not given to women during their pregnancy.
The Centers for Disease Control and Prevention (CDC), on their Morbidity and Mortality Weekly Report (MMWR) from May 12, posted three case studies of pregnant women and their experiences with H1N1-swine influenza infection. While not representative of the general population, or the pregnant population in the United States, these case studies help put a face on influenza infection and what it is capable of doing. The overall case study looked at 20 pregnant women, 15 of whom were confirmed as having H1N1-swine influenza infection while the other 5 were probable cases (symptoms but no lab confirmation).
Pregnant women are at greater risk of complications if they become infected with influenza. These complications include spontaneous abortion, fetal defects, pre-term labor, and other complications. So vaccination for influenza is recommended for women who plan to be pregnant during the flu season or already pregnant. This recommendation only covers the traditional flu shot and not the nasal vaccine. The nasal vaccine contains a live virus that is not recommended for people with weakened or compromised immune systems, like pregnant women.
Despite these recommendations, a very low percentage of pregnant women get vaccinated according to a national survey of obstetricians/gynecologists. That survey revealed that very few OB/GYN practitioners recommended the vaccine. More did not recomment the vaccine for a variety of reasons, including misinformation about vaccination and pregnancy. So ask your provider how much he or she knows about the vaccines available to you if you are pregnant or are planning on being pregnant.
If you are pregnant now, while there is no vaccine for H1N1-swine influenza yet, there are plenty of steps you can take to prevent becoming infected. Just like everyone else, you must wash your hands, stay away from crowds and sick people (if you can), eat a balanced diet, and get plenty of rest. Above all, get prenatal care and follow the directions of your healthcare provider. Your provider will be the best source of information on how to keep yourself and your unborn child healthy.
Whether you plan on being pregnant or not, get your seasonal flu vaccine come September/October. The American Lung Association has a great tool that you can use to track down influenza vaccine clinics near you, some are even free. Worried about thimerosal (a vaccine preservative containing mercury) and how it might affect your baby? Don't. A study of over 2000 women who received the thimerosal-containing vaccine found no adverse effects to the baby. Still worried? There is plenty of vaccine without thimerosal, though it's a little more expensive than the regular vaccine. Ask your provider.
Comments
Pregnant and nursing women have a very large vitamin D requirement, not only for the developing fetus or nursing infant but also for strengthening the innate immune system. Bruce Hollis, Ph.D. recommends 4000-6000 IU/day of vitamin D3 (one can make 10,000 IU/day in the sun with whole body exposure in the summer in an hour more or less, so this amount is safe). Vitamin D reduces the risk of seasonal influenza and improves survival for pandemic influenza. We are not sure what the effect is with the current A/H1N1 influenza virus, but vitamin D cannot hurt. For more information, go to www.pubmed.gov and search for papers using key words such as vitamin D, pregnancy, influenza.
Very timely article. One thing: I believe the thimerisol-free vaccine you are referring to is the live intranasal spray which I don't think is recommended for pregnant women. May want to check on that.
There are both spray and shot vaccines without thimerosal available. A quick Google search will lead you to the manufacturers' websites and CDC websites about this.
What kind of whackjob would ever think that injecting large quantities of one of the most toxic forms of mercury directly into the bloodstream of a pregnant woman would cause harm? These peolpe also believe in global warming. Leave science decisions to Doctors. They have been taught to only tell the truth (not like Jenny McCartney). Thank you so much Rene.
@Ilovemydoctor - The same kind of "whackjob" that criticizes thimerosal without having first taken some basic organic chem to know that the mercury in thimerosal is not the biologically active form and that you get hundreds more times the mercury through your drinking water and your interaction with the environment.
You may want to open up that chemistry book Rene.
Myth: Thimerosal, when used in vaccines, is added in trace amounts.
Fact: Thimerosal is added at a concentration of 1:10000. This is equivalent to a concentration of 100,000 parts per billion (ppb). Since thimerosal is half mercury, this puts the concentration of mercury, in the multi-dose vaccine vial at 50,000 ppb. This can be confirmed by simply analyzing the multi-dose vial. To put this in perspective, liquid waste that exceeds 200 ppb of mercury must be disposed of in a special hazardous waste landfill. Drinking water cannot exceed 2 ppb mercury. "Trace" would probably be the last word to use when describing the amount of mercury in vaccines. Is it really safe to inject infants with levels of mercury 250 times higher than hazardous waste levels?
Rene says:
"@Ilovemydoctor - The same kind of "whackjob" that criticizes thimerosal without having first taken some basic organic chem to know that the mercury in thimerosal is not the biologically active form."
Is this what you mean by biologically inactive Rene;
Myth: Ethylmercury, the type of mercury found in vaccines is less toxic than methylmercury.
Fact: In a paper published in Environmental Health Perspective, August 2005, it was shown that infant primates, exposed to injected ethylmercury, retain twice as much inorganic mercury in their brains than
primates exposed to equal amounts of ingested methyl mercury. Once organic mercury (ethyl and/or methy) is converted to inorganic mercury in the brain, it becomes permanently trapped and neuroinflammatory disease occurs. (Environmental Health Perspectives, vol. 113, #8, 8/2005, pg.1015-1021).
@Amy - One half of 1:100,000 is 1:200,000. They're concentrations. And I like how you tried to pull the old "it's in the vial" trick. How much of the MULTI-DOSE vial do you actually give with the vaccine?
@Polly - I like how you failed to mention what the concentrations of mercury used were. That same approach was used by people who almost outlawed saccharin by telling us about a study where rats died... The rats were being given the equivalent of a dump truck of the stuff.
If I have been given every vaccine known to man, because of where I live and because of my job with infectious diseases, why have I not died? I mean, if we're going to use anecdotal evidence and all.
At any rate, discussion on this article is closed, and further comments will be deleted. Move on, now... There's nothing to see here.
I bet the University of Texas is proud to have a graduate as smart as you Rene. You're a real hoot!
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