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Oct 29, 2009 Studies Show Flu Vaccines Safe in Pregnancy and Risks of Disease risk of maternal or fetal complications associated with inactivated flu can play a pivotal role in helping to protect women and newborns from this
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By Gene Emery
BOSTON (Reuters) - Flu shots given to pregnant women a month or more before delivery will prevent most cases of influenza during the first six months of their babies' lives, researchers said.
"Immunize the mother and you protect the infant," Dr. Mark Steinhoff, a pediatrician with the Johns Hopkins University Bloomberg School of Public Health, said in a telephone interview.
The shots are not licensed for children younger than six months old -- who are in turn more likely to be hospitalized for influenza than any other group.
In the test of 340 pregnant women in Bangladesh, the shots cut the risk of flu by 63 percent and the risk of respiratory illness overall by 29 percent. There were six confirmed cases of influenza in the vaccinated group, compared to 16 among the mothers given a different vaccine.
The injections also lowered the likelihood of fever and respiratory illness among the mothers by 36 percent.
Doctors have known for years that immunizations given to a woman can protect her newborn, so there was no reason to believe the flu vaccine would not work the same way, said Steinhoff. "We always assumed it, but nobody's done the study before," he said.
Flu shots have been recommended for pregnant women by the U.S. Centers for Disease Control and Prevention since 1997, but the advice has been widely ignored, he said. The new study, published in the New England Journal of Medicine, may change that.
"This might persuade more mothers to say, 'Hey, it really helps me and it really helps the baby,'" Steinhoff said.
Only 15 percent of pregnant U.S. women receive the vaccine each year.
The vaccinations in the Bangladesh study were given during the third trimester because in 2004 and 2005, "at the time we did the study, that was the recommendation," he said.
The current advice to pregnant women is to get the vaccine during the flu season, although it takes about a month for the protection to build in the baby. (Editing by Maggie Fox and Cynthia Osterman)
http://www.reuters.com/article/healthNews/idUSN1726328620080917
Published at www.nejm.org September 17, 2008 (10.1056/NEJMoa0708630)
Effectiveness of Maternal Influenza Immunization in Mothers and Infants
(http://content.nejm.org/cgi/content/short/NEJMoa0708630v1?rss=1&query=current)
K. Zaman, M.B., B.S., Ph.D., Eliza Roy, M.B., B.S., D.C.H., Shams E. Arifeen, M.B., B.S., Dr.P.H., Mahbubur Rahman, M.B., B.S., Ph.D., Rubhana Raqib, Ph.D., Emily Wilson, M.H.S., Saad B. Omer, M.B., B.S., Ph.D., Nigar S. Shahid, M.B., B.S., M.P.H., Robert E. Breiman, M.D., and Mark C. Steinhoff, M.D. Visit Our New Web Site!::
File Format: PDF/Adobe Acrobat - Quick ViewOct 1, 2008 diseases. Babies need a number of shots from the time they are born until they are 2 years old. Varicella vaccine to protect against chickenpox. A flu shot longer cover Maternal and. Infant Health Programs (also
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ABSTRACT
Background Young infants and pregnant women are at increased risk for serious consequences of influenza infection. Inactivated influenza vaccine is recommended for pregnant women but is not licensed for infants younger than 6 months of age. We assessed the clinical effectiveness of inactivated influenza vaccine administered during pregnancy in Bangladesh.
Methods In this randomized study, we assigned 340 mothers to receive either inactivated influenza vaccine (influenza-vaccine group) or the 23-valent pneumococcal polysaccharide vaccine (control group). Mothers were interviewed weekly to assess illnesses until 24 weeks after birth. Subjects with febrile respiratory illness were assessed clinically, and ill infants were tested for influenza antigens. We estimated the incidence of illness, incidence rate ratios, and vaccine effectiveness.
Results Mothers and infants were observed from August 2004 through December 2005. Among infants of mothers who received influenza vaccine, there were fewer cases of laboratory-confirmed influenza than among infants in the control group (6 cases and 16 cases, respectively), with a vaccine effectiveness of 63% (95% confidence interval [CI], 5 to 85). Respiratory illness with fever occurred in 110 infants in the influenza-vaccine group and 153 infants in the control group, with a vaccine effectiveness of 29% (95% CI, 7 to 46). Among the mothers, there was a reduction in the rate of respiratory illness with fever of 36% (95% CI, 4 to 57).
Conclusions Inactivated influenza vaccine reduced proven influenza illness by 63% in infants up to 6 months of age and averted approximately a third of all febrile respiratory illnesses in mothers and young infants. Maternal influenza immunization is a strategy with substantial benefits for both mothers and infants. (ClinicalTrials.gov number, NCT00142389 [ClinicalTrials.gov] (http://content.nejm.org/cgi/external_ref?access_num=NCT00142389&link_type=CLINTRIALGOV) .)
Source Information
From the International Centre for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z., E.R., S.E.A., M.R., R.R., N.S.S., R.E.B.); and the Bloomberg School of Public Health (E.W., S.B.O., M.C.S.), Institute for Vaccine Safety (S.B.O.), and Department of Pediatrics, School of Medicine (M.C.S.) — all at Johns Hopkins University, Baltimore.
This article (10.1056/NEJMoa0708630) was published at www.nejm.org on September 17, 2008. It will appear in the October 9 issue of the Journal.
Address reprint requests to Dr. Steinhoff at the Children's Global Health Center, Cincinnati Children's Hospital, 3333 Burnet Ave., MLC 2048, Cincinnati, OH 45229, or at m.steinhoff@gmail.com (m.steinhoff@gmail.com) .
Full Text of this Article (http://content.nejm.org/cgi/content/full/NEJMoa0708630v1)
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