Maternal Immunization

As we enter flu season , let’s review some important immunization information. Young parents, and in particular expectant mothers are an important population of citizens who should keep their immunization status current.  This involves in particular 2 shots–TdaP and, in this season, flu shots.  Children under 6 months old are ineligible to receive flu vaccine so their only protection comes from immunizing their contacts.  Under 2 months they also have not received whooping cough vaccine yet, so, again, prevention by keeping that infection out of their environment is essential to protect them.

But that protection goes even further.  Both vaccines provide antibodies that cross the placenta and provide good immunity to the baby from even before actual birth. As 80% of whooping cough infections occur before 2 months of age–before they have even received their first shot–and 70% of infant deaths occur in that age group, this early maternal conveyed immunity can be life saving.  In a typical year 20 infants < 2 months of age will die from pertussis. Studies demonstrate that hospitalization for pertussis in this age group is decreased 90% when mother’s receive prenatal TdaP. Therefore, it is recommended that women receive TdaP with each pregnancy between week 27-36.

Also note that infants <6 months of age are at greater risk for hospitalization from flu compared to older children, as well as many serious complications from that infection–pneumonia, secondary bacterial sepsis, or encephalopathy(brain swelling). If the baby has other health problems like prematurity, genetic or chromosome abnormalities like Down Syndrome, or heart disease, that merely ups the ante for this risk. Maternal prenatal immunization lowers infant hospitalization rates for influenza by 77.7%.

Influenza, of course, poses substantial risk for pregnant women themselves.  While approximately 9% of women age 15-44 are pregnant during flu season, 23-44% of women in that age group who require hospitalization are pregnant. Of additional concern is that influenza is an important risk factor for the pregnancy and is a frequent cause of complications like premature birth.  Studies indicate that maternal prenatal flu immunization lowers that risk by 40%.

Only 59% of pregnant women get flu shots and 55% get TdaP; only 35% get both. Both vaccines are recommended for all pregnant women (flu in season).  They are both safe and effective. The leading reason for not immunizing is not knowing the recommendation.

So I’m telling you now. Expectant Mom’s (and Dads!)–talk to your primary care physician (mothers to OB) about flu and TdaP vaccine.  Call me and let’s talk about it. It may very well save your baby’s life.

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