May 31st, 2019

Influenza Vaccination Recommendation Clarified for Pregnant Women

All pregnant women during flu season should receive an inactivated influenza vaccine during any trimester says ACOG

pregnant woman

Most healthcare providers say the annual influenza vaccination is an essential element of pre-pregnancy, prenatal, and postpartum care.

This is because when a pregnant woman catches influenza, it increases the chance of progressing into pneumonia when it occurs during the antepartum or postpartum period.

Effective today, The American College of Obstetricians and Gynecologists (ACOG) is also supporting this recommendation.

"The American College of Obstetricians and Gynecologists recommend that all pregnant women should receive a flu shot as soon as it becomes available to protect both themselves and their baby from the flu and the complications that can arise from it,” said Alexandria Duffield, Pharm.D. MTM Clinical Pharmacist at Brookshire Grocery Company.

The following ACOG recommendations were made in collaboration with the Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices:

  • All women who are or will be pregnant during influenza (flu) season receive an inactivated influenza vaccine during any trimester.
  • Obstetrician-gynecologists and other healthcare providers should counsel pregnant women about the safety and benefits of influenza immunization for themselves and their fetuses and advocate for the benefits of passive immunity from maternal immunization for their newborns.
  • Obstetrician-gynecologists are encouraged to stock and administer the influenza vaccine to their pregnant patients.
  • If the influenza vaccine cannot be offered in a practice, obstetrician-gynecologists and obstetric care providers should refer patients to another healthcare provider, pharmacy, or community vaccination center.
  • Obstetrician-gynecologists should strongly encourage their office staff to be vaccinated against influenza every season.
  • Individuals with a history of egg allergy who have experienced only hives after exposure to egg can receive any licensed and recommended influenza vaccine that is otherwise appropriate for their age and health status.
  • In the case of allergic symptoms more serious than hives, the vaccine should be administered in an inpatient or outpatient medical setting, including, but not necessarily limited to hospitals, clinics, health departments, and physician offices.
  • Patients with flu-like illness should be treated with antiviral medications presumptively regardless of vaccination status. Health care providers should not rely on test results to initiate treatment and should treat patients presumptively based on clinical evaluation.
  • Because of the high potential for morbidity, the CDC and ACOG recommend that postexposure antiviral chemoprophylaxis (75 mg of oseltamivir once daily for 10 days) be considered for pregnant women and women who are up to 2 weeks postpartum (including pregnancy loss) who have had close contact with someone likely to have been infected with influenza. If oseltamivir is unavailable, zanamiver can be substituted, two inhalations once daily for 10 days.

This Committee Opinion was developed by the American College of Obstetricians and Gynecologists’ Immunization and Emerging Infections Expert Work Group and the Committee on Obstetric Practice in collaboration with Neil S. Silverman, MD, and Richard Beigi, MD.

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