March 14, 2008

Can I Get The Flu Shot While Pregnant?

(I have noticed a lot of people coming to my blog from the "Can I get the flu shot while pregnant" search term. They have been referred to another post of mine, "Did You Get The Flu Shot While Pregnant". Feel free to visit that post, which is on mom's reports of long term damage done to their kids from getting the flu shot, but I thought I should write something that more directly speaks to this question:)

The CDC and it's Advisory Committee on Immunization Practices (ACIP) recommends the flu shot for pregnant women.

However, I believe that this is an irresponsible recommendation as the flu shot has not been safety tested on pregnant women.

And despite the fact that some of these flu vaccines are not for use in children, the CDC and ACIP have not issued a warning for pregnant women not to have them.

Additionally, despite repeated requests from parents of vaccine injured children, the CDC and ACIP will not state a preference for pregnant women to receive only Thimerosal free flu shots.

From the vaccine package inserts:

Fluarix (Thimerosal free):
Pregnancy: Pregnancy Category C. Animal reproduction studies have not been conducted with FLUARIX. It is not known whether FLUARIX can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. FLUARIX should be given to a pregnant woman only if clearly needed. The ACIP has issued recommendations regarding the use of the influenza virus vaccine in pregnant women.

Nursing Mothers: It is not known whether FLUARIX is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when FLUARIX is administered to a nursing woman. The ACIP has issued recommendations regarding the use of the influenza virus vaccine in nursing mothers.

Pediatric Use: FLUARIX IS NOT INDICATED FOR USE IN CHILDREN.


Flulaval (Contains Thimerosal):
Pregnancy: Pregnancy Category C. Animal reproduction studies have not been conducted with FLULAVAL. It is also not known whether FLULAVAL can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. FLULAVAL should be given to a pregnant woman only if clearly needed.

Nursing Mothers: It is not known whether FLULAVAL is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when FLULAVAL is administered to a nursing woman.

Pediatric Use: Safety and effectiveness of FLULAVAL in pediatric patients have not been established.


Flumist (Thimerosal Free):
Pregnancy: Pregnancy Category C Animal reproduction studies have not been conducted with FluMist. It is not known whether FluMist can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. FluMist should be given to a pregnant woman only if clearly needed.
The effect of the vaccine on embryo-fetal and pre-weaning development was evaluated in a developmental toxicity study using pregnant rats receiving the frozen formulation. Groups of animals were administered the vaccine either once (during the period of organogenesis on gestation day 6) or twice (prior to gestation and during the period of organogenesis on gestation day 6), 250mcL/rat/occasion (approximately 110-140 human dose equivalents based on TCID50), by intranasal instillation. No adverse effects on pregnancy, parturition, lactation, embryo-fetal or preweaning development were observed. There were no vaccine related fetal malformations or other
evidence of teratogenesis noted in this study.

Nursing Mothers: It is not known whether FluMist is excreted in human milk. Therefore, as some viruses are excreted in human milk and additionally, because of the possibility of shedding of vaccine virus and the close proximity of a nursing infant and mother, caution should be exercised if FluMist is administered to nursing mothers.

Pediatric Use: FluMist is not indicated for use in children <24 months of age. FluMist use in children <24 months has been associated with increased risk of hospitalization and wheezing in clinical trials [see Warnings and Precautions (5.1) and Adverse Reactions (6.1)].



Fluvirin (Contains Thimerosal)
Pregnancy: Pregnancy Category C
Animal reproduction studies have not been conducted with Influenza Virus Vaccine (FLUVIRIN®). It is also not known whether Influenza Virus Vaccine (FLUVIRIN®) can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Influenza Virus Vaccine (FLUVIRIN®) should be given to a pregnant woman only if clearly needed.
The clinical judgment of the attending physician should prevail at all times in determining whether to administer Influenza Virus Vaccine to a pregnant woman.

Pediatric Use: The safety and immunogenicity of FLUVIRIN® have been established in the age group 4 years to 16 years. The use of FLUVIRIN® in these age groups is supported by evidence from adequate and well-controlled studies of FLUVIRIN® in adults that demonstrate the immunogenicity of FLUVIRIN®. The safety and immunogenicity of FLUVIRIN® have not been established in children <4 years of age.



Fluzone (Comes in both Thimerosal Containing and Thimerosal Free):
PREGNANCY CATEGORY C
Animal reproduction studies have not been conducted with Influenza Virus Vaccine. It is not known whether Influenza Virus Vaccine can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Influenza Virus Vaccine should be given to a pregnant woman only if clearly needed. For guidance regarding use in pregnant women, see INDICATIONS AND USAGE section.

PEDIATRIC USE: SAFETY AND EFFECTIVENESS OF FLUZONE VACCINE (SUBVIRION) IN INFANTS BELOW THE AGE OF 6 MONTHS HAVE NOT BEEN ESTABLISHED.

8 comments:

Maureen_MD said...

Thank you for this post. I am 29 and 16 weeks into my first pregnancy. I am overwhelmed with angst, between the physician recommendation to have a flu vaccine (including a recent Hopkins study I saw on the news about a month ago) and these warnings from parents with concerns about the relationship between vaccinations and autism.
My doctor's office uses Fluarix; would you consider that "safe" because it doesn't contain thimerosal? The list of complications from getting the flu is startling, the fear of harming my child with a vaccine is equally upsetting. I've never had a flu shot; is now the time to start? Help!

Ginger Taylor said...

Maureen,

I hear this SO much.

First... let go of the angst. I ALWAYS council parents not to make decisions out of fear. Don't vaccinate because you are afraid of diseases, don't NOT vaccinate because you are afraid of autism. Accept that there will always be risks that your baby faces, do good research, and make your decision on what you believe is wise.

And most importantly, make YOUR OWN decision. Don't let a vaccine pushing doctor or a vaccine phobic autism mom make your decision for you. You and your baby are the only ones who have to live with the consequences of your decisions, so don't let yourself be pushed into something that goes against your best judgment.

Second, with out question, if you decide to get a flu shot, make sure it is thimerosal free. The amount of mercury in a flu shot is 25mg, which the EPA says is safe for someone who ways 550lbs. Unless both you and your baby weigh 550, the EPA says that is an unsafe mercury exposure.

When one nurse/autism mom went to a CDC vaccine meeting and during the public comments asked the committee why CDC would not recommend that pregnant women get mercury free shots, she was told to sit down and stop asking questions.

That does not give me confidence in the CDC recommendation for pregnant women to get flu shots. Especially considering that they are not tested on pregnant women and CDC cannot say that they are safe.

Two weeks ago I was talking to a doctor, a Navy Flight shot whose sister in law was having a baby and I started going off on how the CDC recommends the shot for pregnant women even though it was not tested on them. He said that he would not recommend it for pregnant women, simply because it they did get a serious case of the flu, they could easily be maintained in the hospital at less risk to baby.

I don't know of any reports of long term damage to a baby if mom gets the flu. My understanding is that it is recommended because pregnant women have a higher chance of getting secondary bacterial infections during a bout of the flu. But I don't think that there are serious chances of long term effects from that.

And consider the priorities of the person you are asking. I am an autism mom so I make decisions based on the question, "what are the long term consequences of this choice", not "will my kid ever get sick". A doctor might be answering your question from the standpoint of, "will not getting the shot allow this person to get the illness or end up in the hospital".

After dealing with autism, I would happily trade having my child be hospitalized once a year for viral infections. Not only would I happily take the flu, I would happily take the measles.

CDC reports that about 100 children die a year from the flu. I have not heard of any spontaneous abortions from the flu. Sadly I know of many women who got the flu shot and attribute their child's disability or disease to it.

Get in touch with the CDC or whoever is encouraging you to get the shot and see if their reasoning sounds convincing to you. Then read the ingredients of the shot and the vaccine package inserts to see if you think that the benefits that they claim you will get from the shot are worth the risks that are listed on the packaging.

While I don't believe the benefits outweigh the risks, again, I don't have to live with the consequences of your decisions.

I strongly encourage you and all parents to take their health in their own hands, read much, and be wise.

But I MUST insist that you pack that big ole' pregnant body full of fresh, organic fruits and veggies, (also look into some good probiotics, steer clear of genetically modified foods and go easy on the milk) because that will do the absolute most to prevent the flu and any other potential yuckyness that might try to head your way.

Be wise, no worries, learn to trust that wonderful mommy instinct that God is giving you even now and enjoy the heck out of that amazing pregnancy!

Ginger Taylor said...

I don't think I answered all your questions... sorry:

"My doctor's office uses Fluarix; would you consider that "safe" because it doesn't contain thimerosal?"

I consider it 'safer' but I don't consider any vaccine 'safe' because they are all pharmaceuticals and there is no such thing as a pharmaceutical that is safe for everyone. Some people will have adverse reactions to a single aspirin.

When people say that any medication is "safe", I now automatically think, "well safe for who and under what circumstances"? Blanket safety statements don't fly with me any more. I want to know who got sick from it and do they have anything in common with me or my kids.

Because in our case, we didn't know were were on the end of the bell curve until it was too late. (If I had known that the colic, fevers and GI problems that Chandler had after his first round of shots were common among children who eventually regressed into autism after their 1 year/18 month/2 year shots, I would have stopped vaccinating him. Or at least waited a few years and done them one at a time.)

And the vaccine/autism connection is not just about thimerosal. Because the adjuvants in vaccines tip some people into an autoimmune state (and in some cases sets the immune system to attack the central nervous system like in Guillain-Barré and Autism) just being thimerosal free does not make it completely exonerated from triggering autism or other autoimmune disorders.

Additionally, the viruses themselves from the vaccines are implicated in autism, but I think that this applies mostly to measles and rubella viruses. I don't believe that the vaccine strains of the flu vaccines play any role in autism.

"I've never had a flu shot; is now the time to start? Help!"

If you have never had the flu shot before, I don't know that this is the best time to start getting them. But I am not speaking from a position of researched knowledge on this point just mommy instinct.

If your body has been good at fighting off the flu, why mess with success?

Hannah P said...

I just got a flu vaccine, because it's my first pregnancy and I didn't know better. They gave me flulaval, and when I looked it up, it says to only give to pregnant women if there is a clear need. I'm beside myself. What do I do???? I'm never going back to this doctor, and I'm going to a look into a natural birthing center. I'm just appalled that they don't even offer options.

Ginger Taylor said...

Hannah,

I am sorry you had to learn about this after the fact. Doctors just give these shots on impulse to pregnant woman, they do as they are told and rarely ever read the package insert.

This is a full dose mercury vaccine. I would get in touch with a naturopathic doc or environmental medicine specialist and look at some natural detox methods.

Don't delay. Get this stuff out of you asap.

Theresa Wong said...
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Theresa Wong said...
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Theresa Wong said...

"But I MUST insist that you pack that big ole' pregnant body full of fresh, organic fruits and veggies, (also look into some good probiotics, steer clear of genetically modified foods and go easy on the milk) because that will do the absolute most to prevent the flu and any other potential yuckyness that might try to head your way."

Thank you for this post. I'm 17 weeks and my doctor is suggesting the flu shot, but the whole idea scares me. After reading this, I've decided not to get it. Now I'm just curious as to why you suggest we go easy on milk?