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Baby Love in the Time of H1N1 Moms-to-be and doctors are on high alert to protect both mom and baby from the swine flu - vaccine or no vaccine 
Merriah Fairchild is pregnant with her first child and due to give birth mid-November. While the mom-to-be, a resident of Portland, Ore., has already received a seasonal flu shot, she is hesitant to add the H1N1 vaccine into the mix. On one hand, her midwife is concerned about the largely untested nature of the vaccine. "But on the other hand, my sister - a doctor - is terrified that I will die if I don't get it," Fairchild says. Many pregnant women who get the flu have no complications. However, due to a naturally compromised immune system while pregnant, they are statistically more likely to develop a severe case, potentially resulting in pre-term labor, or worse. In the weekly briefing on H1N1 flu and vaccine distribution held October 23, Dr. Thomas Frieden, cirector of the Centers for Disease Control and Prevention (CDC), said that women are about six times more likely to die from H1N1 influenza if they are pregnant. "The most recent numbers released, in early October, report that 28 pregnant women have died from H1N1 in the U.S.," says Amanda Dudley, a spokesperson for the CDC. "Which is really, really sad." Still, a significant portion of Americans continue to have reservations about the swine flu vaccine. A CNN/Opinion Research Corporation telephone poll of 1,038 adult Americans conducted October 16-18 found that 49 percent of people said they thought it was safe, while 43 percent said it wasn't. And there are various reports across the country of pediatricians and OB/GYNs who continue to mistrust the new shot. Frieden understands this reluctance to accept a vaccine that appears to be different, but notes that the only difference between the H1N1 and seasonal vaccines is the flu strain in the vaccine; otherwise, they are made with the same manufacturing process, by the same manufacturers, in the same factories, using the same safeguards. "We are using a tried and true technology," he says. Dudley adds that the seasonal flu shot has been tested on and given to millions of pregnant women over many years and has a great track record. And research has shown that getting the seasonal shot allows the mother to pass on some measure of protection to her baby in the first six months of its life, she says. This is the outcome that has Fairchild leaning more toward getting the vaccine. "I think I'd be OK," she says, "but I'm worried about my new baby." The CDC warns that moms-to-be should only get the "flu shot" - the injectable form made with killed flu virus; they should not receive the nasal-spray, which is made with live, weakened flu virus and only approved for healthy, not-pregnant people age two to 49. (The mist is safe for women after they have delivered, even if they are nursing.) However, women with egg allergies cannot get any form of the vaccine, as the H1N1 strain is grown in chicken eggs. Because some pregnant women are concerned about thimerosal (a mercury preservative used in multi-dose vials), companies are now making both preservative-free H1N1 and seasonal flu vaccines in single dose syringes. (Frieden states that there is no evidence that thimerosal is harmful to pregnant women.) Single-dose versions of the vaccine are currently more difficult to find, and vaccine availability in general is far shy of where the government expected it to be by now; but many clinics are giving priority to pregnant women, in addition to caregivers and family members of children younger than six months. If a pregnant woman has not yet been inoculated, she should keep an eye out for common symptoms associated with H1N1, which can - but may not necessarily - include fever, cough, sore throat, runny or stuffy nose, body aches, headaches, chills, fatigue, diarrhea and vomiting. She should call her doctor right away if she experiences any of these symptoms and thinks she has the flu. If she does, in fact, have H1N1, the vaccine is no longer effective, but her doctor may prescribe antiviral drugs such as Tamiflu (oseltamivir) or Relenza (zanamivir) that prevent germs from growing. Although these medications are "Pregnancy Category C," indicating that no clinical studies have been conducted to assess their safety for pregnant women, the CDC states that the available risk-benefit data indicates pregnancy is not contraindicated with use of either drug. Both work best if they are taken as soon as possible after symptoms of the flu appear. However, the CDC notes that if a pregnant woman with flu-like symptoms also experiences difficulty breathing or shortness of breath, pain or pressure in the chest or abdomen, sudden dizziness, confusion, severe or persistent vomiting, a high fever that doesn't respond to acetaminophen or decreased or no movement of her baby, it is time to call 911. |
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