Priority for Limited Influenza Vaccination: Pregnant Women
When influenza vaccine supply is limited, pregnant women should be prioritized for vaccination among the options listed. 1
Rationale Based on ACIP Guidelines
The Advisory Committee on Immunization Practices (ACIP) explicitly identifies pregnant women as a top-tier priority group during limited vaccine availability scenarios. 1 This recommendation is based on:
High-Risk Status for Severe Complications
- Pregnant women face increased morbidity and mortality from influenza infection, particularly highlighted during the 2009 H1N1 pandemic when they experienced heightened complications and death rates. 2, 3
- Influenza infection during pregnancy can compromise both maternal and fetal outcomes, including increased risk of hospitalization and severe illness. 3
ACIP Priority Framework During Shortages
When vaccine supply cannot meet demand for all five initial target groups, ACIP recommends a subset of priority populations, with pregnant women consistently listed first:
- Pregnant women (highest priority)
- Persons who care for infants <6 months
- Healthcare personnel with direct patient contact
- Children aged 6 months-4 years
- Children/adolescents aged 5-18 years with high-risk medical conditions 1
Analysis of Other Options
School children (Option A): While children aged 6 months-24 years are in the broader target group, healthy school-age children without medical conditions are not prioritized during limited supply. 1 Only younger children (6 months-4 years) or those with high-risk medical conditions receive priority. 1
Idiopathic adult hypertension (Option C): Isolated hypertension is explicitly excluded from high-risk conditions warranting priority vaccination. 1 ACIP guidelines specifically state "cardiovascular disease (except isolated hypertension)" as a priority condition. 1
Iron deficiency anemia in children (Option D): Iron deficiency anemia alone does not constitute a high-risk condition for influenza complications unless associated with hemoglobinopathies or other chronic hematologic disorders requiring regular medical follow-up. 1
Clinical Considerations
- The recommendation for pregnant women applies regardless of trimester, though vaccination is particularly emphasized for those who will be in second or third trimester during influenza season. 1
- Influenza vaccines have been administered to millions of pregnant women with demonstrated safety profiles and benefits for both mothers and infants. 3
- Vaccination protects not only the pregnant woman but also provides passive immunity to the newborn during the vulnerable first months of life. 2
Answer: B - Pregnant women