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Having A Baby? Have A Shot

Reassurance for Pauline Hanson followers, with a new Australian study showing flu vaccine given to women at any stage of pregnancy is safe in terms of preterm birth and infant birthweight.

The FluMum study, published recently in the journal Vaccine looked at over 7100 pregnant women, a third of whom received the flu vaccine at some stage in their pregnancy. Rates of these two critical safety outcomes, prematurity and birth weight, were the same in the vaccinated group as in the unvaccinated group.

The positive results should allay some of the fears about vaccine safety held by both families and even the vaccine providers that are known to influence the uptake of flu immunisation during pregnancy, the researchers suggested.

And this latest evidence supports the most recent update in the Australian Immunisation Handbook which recommends flu vaccine in all pregnant women with timing dependent only on the flu season and the vaccine availability.

“The timing isn’t as important as ensuring the baby is protected by that transplacental antibody transfer,” said Associate Professor Kristine Macartney, staff specialist in infectious diseases and Microbiology at the Children’s Hospital at Westmead, Sydney.

Speaking at the recent Women’s and Children’s Health Update conference in Melbourne, Professor Macartney said the reality is pregnant women and young children get bad influenza. In the decade between 2002 and 2013, the incidence of hospitalisations for influenza was about 180 per 100,000 in the 1-5month age group, compared to less than 40 per 100,000 in the 2 to 4 year age group.

Vaccinating during pregnancy protects both mum and bub, Professor Macartney said, and yet there is still a reluctance to have the flu immunisation as evidenced in this latest study where only 34% of the pregnant women accepted the offer to receive the vaccine.

In addition, the poor uptake of the pertussis vaccination during pregnancy was putting young infants at needless risk. Whereas flu has the potential to cause significant morbidity in both the pregnant woman and the young child, pertussis poses the greatest risk to young infants in the period prior to their first DTPa vaccination.

Giving a single dose of dTpa in the third trimester of each pregnancy, as recommended in the Australian Immunisation Handbook is 92% effective in protecting infants under three months of age, Professor Macartney said.

The optimal time for pertussis vaccination is early in the third trimester, between 28 and 32 weeks, she said, but it will still be effective if given at any time in the third trimester up to delivery and even slightly before 28 weeks.

Like the flu vaccine, there is robust evidence supporting the safety of pertussis vaccination in pregnancy, but like flu vaccine the biggest barrier to pertussis vaccine uptake is parental reluctance.

Better resources are being developed by the National Centre for Immunisation Research and Surveillance to give to vaccine-hesitant patients, Professor Macartney said, but regardless of this, GPs can help improve uptake by recommending these vaccinations to all pregnant women and help lower the morbidity and mortality risk to possibly our most vulnerable patients.