From the Guidelines
The flu vaccine is safe and recommended during pregnancy, with the inactivated influenza vaccine (IIV) being the preferred choice, as stated by the American College of Obstetricians and Gynecologists and the American Academy of Family Physicians 1. The recommendation for influenza vaccination during pregnancy is based on strong evidence that it protects against influenza and its complications in pregnant individuals and their infants 1.
Key Points
- Influenza vaccination is recommended for all pregnant individuals, during any trimester of gestation, to protect against influenza and its complications 1.
- The IIV prevents laboratory-confirmed influenza disease and its complications in pregnant individuals and protects their infants in the first months of life (up to 6 months) through transplacental passage of antibodies 1.
- Vaccination during pregnancy has been shown to be beneficial, with studies reinforcing the benefits of influenza vaccination during pregnancy to infants 1.
Important Considerations
- Racial disparities in uptake of influenza vaccine during pregnancy have been identified, with Black women consistently having the lowest rates 1.
- Lower influenza vaccination coverage has also been reported in Medicaid-insured pregnant women compared with privately insured women and in women residing in rural areas compared with those residing in urban areas 1.
- A provider recommendation is associated with vaccine acceptance, highlighting the importance of healthcare providers in promoting influenza vaccination during pregnancy 1.
From the Research
Safety and Efficacy of Flu Vaccine During Pregnancy
- The flu vaccine is considered safe and effective for use during pregnancy, with studies showing that it can provide direct protection to pregnant women and passive immunity to infants up to 6 months of age via maternal antibodies 2, 3.
- Experimental and observational evidence support the efficacy, effectiveness, and safety of influenza immunization during pregnancy, with a review of published articles finding that the inactivated influenza vaccine can be provided to pregnant women as recommended by global immunization policies 2.
- A systematic review and meta-analysis of 19 studies found that the influenza vaccine was effective in preventing laboratory-confirmed influenza among pregnant women, with a lower risk of getting influenza-like illness and respiratory illness 3.
- Another study found that vaccination of pregnant women might be beneficial for their newborns, and vaccination of children might be protective in non-recipients of the vaccine of all ages living in the same community 4.
Benefits of Flu Vaccine During Pregnancy
- The flu vaccine can help prevent severe complications from influenza infection in pregnant women, who are at higher risk of complications compared to the general population 2, 5.
- The vaccine can also provide protection to infants up to 6 months of age via maternal antibodies, which can help prevent influenza-like illness and respiratory illness in this vulnerable population 2, 3.
- Annual vaccination is recommended for pregnant women due to the antigenic changes in circulating strains of the influenza virus, which can help prevent infection and complications 6.
Recommendations for Flu Vaccine Use During Pregnancy
- The flu vaccine is recommended for all pregnant women, unless there is a contraindication, and should be administered at the beginning of the flu season, which typically starts in October 5.
- Healthcare providers should recommend the flu vaccine to pregnant women and provide education on the benefits and risks of vaccination, as well as address any misconceptions or concerns 5, 3.
- Public health efforts are needed to promote physician recommendations of influenza vaccination in pregnancy and to improve access to and uptake of the vaccine among pregnant women 3.