Can a pregnant person receive the influenza (flu) vaccine?

Influenza Vaccination During Pregnancy

Pregnant women should receive the inactivated influenza vaccine (IIV) or recombinant influenza vaccine (RIV) during any trimester of pregnancy, as this is both safe and strongly recommended by current guidelines. 1, 2

Benefits of Influenza Vaccination During Pregnancy

• Maternal Protection: Pregnant women are at increased risk for severe influenza-related complications, including hospitalization and death 2
• Infant Protection: Vaccination provides protection to infants during their first 6 months of life (when they are too young to be vaccinated) through transplacental antibody transfer 1
• Risk Reduction: Infants born to vaccinated mothers have up to 72% reduced risk of laboratory-confirmed influenza hospitalization in the first few months of life 1, 2

Vaccination Recommendations

Recommended Vaccines

• Inactivated influenza vaccine (IIV): Safe during any trimester 1
• Recombinant influenza vaccine (RIV4): Can be used, though experience is more limited 1

Contraindicated Vaccines

• Live attenuated influenza vaccine (LAIV): Contraindicated during pregnancy 1, 2

Timing

• Ideally administered by the end of October, but vaccination throughout the influenza season is encouraged 1
• Early vaccination (during July and August) can be considered for women in their third trimester during these months 1

Safety Data

• Multiple studies confirm the safety of influenza vaccination during pregnancy, including during the first trimester 1
• No increased risk of adverse pregnancy outcomes, including spontaneous abortion, has been consistently demonstrated 1
• A large Vaccine Safety Datalink follow-up study showed no association between IIV and increased risk for miscarriage during the 2012-15 seasons 1

Common Barriers and Misconceptions

Despite strong recommendations, vaccination rates among pregnant women remain suboptimal (38.1-53.7%) 1, 3. Common barriers include:

• Misconceptions about vaccine effectiveness (17.6% of unvaccinated women) 3
• Safety concerns for the infant (15.9%) 3
• Lack of provider recommendation or offer of vaccination 3

Special Considerations

• Egg Allergy: Not a contraindication for influenza vaccination during pregnancy 1
• Breastfeeding: Influenza vaccination is safe during breastfeeding and provides additional protection to infants through breast milk 1, 2
• Racial Disparities: Vaccination rates are highest in non-Hispanic Asian individuals (53.4%) and lowest in non-Hispanic Black individuals (21.5%) 1

Provider Role

Healthcare providers play a critical role in influenza vaccination rates. When providers offer vaccination:

• 71% of pregnant women receive the vaccine (vs. 14% when not offered) 4
• Provider recommendation significantly increases acceptance rates 3

Conclusion

The American Academy of Pediatrics, Advisory Committee on Immunization Practices, American College of Obstetricians and Gynecologists, and American Academy of Family Physicians all strongly recommend influenza vaccination during pregnancy. The benefits of protecting both mother and infant from influenza-related complications clearly outweigh any theoretical risks.