Monday, October 19, 2009

Seasonal flu and H1N1

We have a lot of questions from patients in our practice about the flu and H1N1. Should they get the vaccines, are they safe. Here is some information to help you decide.

Pregnancy and the Flu
Complications of both the seasonal flu and H1N1, like bacterial pneumonia and dehydration, can be serious and even fatal. Pregnancy can increase the risk of these complications. Pregnant women are more likely to be hospitalized from complications of the flu than non-pregnant women who are the same age. Some of the physiological changes in pregnancy, like those to the immune system, heart and lungs, can increase the risk for complications from the flu.
The American College of Nurse-Midwives, the Centers for Disease Control, the American College of Obstetricians and Gynecologists and the March of Dimes have come together to develop a clear statement about the seriousness of H1N1 flu and the importance of receiving the vaccination.

Can the 2009 H1N1 flu vaccine be given at any time during pregnancy?
Seasonal flu vaccine is recommended for all pregnant women at any time during pregnancy, and has not been shown to cause harm to a pregnant woman or her baby. The Advisory Committee on Immunization Practices also recommends that 2009 H1N1 flu vaccine be given to all pregnant women at any time during pregnancy.

If I deliver my baby before I receive my seasonal flu shot or 2009 H1N1 flu shot, should I still receive them?
Yes. In addition to protecting you from infection, the vaccine may also help protect your young infant. Flu vaccines are recommended only for infants 6 months or older. It is recommended that everyone who lives with or provides care for an infant less than 6 months old receive both the seasonal flu vaccine and the 2009 H1N1 flu vaccine.

I am breastfeeding, can I receive the vaccine?
Yes. Both seasonal flu and 2009 H1N1 influenza vaccines should be given to breastfeeding mothers. Breastfeeding is fully compatible with flu vaccination, and preventing maternal infection provides secondary protection to the infant. Maternal vaccination is especially important for infants less than 6 months old, who are ineligible for vaccination. In addition, transfer of vaccination-related antibodies by breastfeeding further reduces the infant’s chances of getting sick with the flu.

Is the 2009 H1N1 flu vaccine safe for pregnant women?
Flu vaccines have not been shown to cause harm to a pregnant woman or her baby. The seasonal flu shot has been recommended for pregnant women for many years. The 2009 H1N1 flu vaccine will be made using the same processes as the seasonal flu vaccine. Studies that test the 2009 H1N1 flu vaccine in pregnant women began in September. More information is available at http://www3.niaid.nih.gov/news/QA/vteuH1N1qa.htm.

Does the 2009 H1N1 flu vaccine have preservative in it?
Multi-dose vials of flu vaccine contain the preservative thimerosal to prevent bacterial growth. There is no evidence that thimerosal is harmful to a pregnant woman or a fetus. However, because some women are concerned about exposure to preservatives during pregnancy, manufacturers are producing preservative-free seasonal flu vaccine and 2009 H1N1 flu vaccine in single dose syringes. CDC recommends that pregnant women receive flu vaccine with or without thimerosal.

Can I get the seasonal flu vaccine and the 2009 H1N1 flu vaccine at the same time?
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, the seasonal vaccine is available now in numerous areas and the 2009 H1N1 influenza vaccine won’t be available until mid-October. So, pregnant women are encouraged to get their seasonal flu vaccine as soon as it is available in their community. The usual seasonal influenza viruses are still expected to cause illness this fall and winter.

Can pregnant women receive the nasal spray vaccine?
The nasal spray vaccine is not licensed for use in pregnant women. Pregnant women should not receive nasal spray vaccine for either seasonal flu or 2009 H1N1 flu. After delivery, women can receive the nasal spray vaccine, even if they are breastfeeding.

What are the possible side effects of the 2009 H1N1 flu vaccine?
Pregnant women are not known to have an increased risk of side effects from the flu vaccine. The side effects from 2009 H1N1 flu 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. Some people might experience headache, muscle aches, fever, fatigue, and nausea. If these problems occur, they usually begin soon after the shot is given and may last as long as 1-2 days. Fainting may occur shortly after receiving any injection and has uncommonly been reported after the flu shot. Like any medicines, vaccines can cause serious problems like severe allergic reactions. However life-threatening allergic reactions to vaccines are very rare.
Anyone who has a severe (life-threatening) allergy to eggs or to any other substance in the vaccine should not get the vaccine, regardless of whether they are pregnant.

What can I do to prevent getting the swine flu?
There are things you can do to prevent getting the the flu. Little things can make a big difference:
* Wash your hands well and often.
* If water or soap are not available, use hand sanitizer.
* When you cough or sneeze, cover your nose and mouth by coughing into your arm. This should be done so that the spray from your cough does not get into the air.
* Properly dispose of your tissue after you use it.
* Wash your hands after coughing or sneezing.
And remember the ‘‘Don’ts’’:
* Don’t touch your nose, mouth, or eyes if you are sick, because that’s where germs like to live.
* Don’t spend time around people who are sick or crowds.
* Don’t go to work or school if you are sick.

Most importantly, call your midwife or doctor if you think you are sick. Medicines are available to help you.

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