Will pregnant women be at the front of the line for vaccine?

Pregnant women

As the H1N1 vaccine starts to roll out across America, in clinics and pharmacies, public health officials and doctors are hoping that pregnant women will be at the front of the line. They should get both the H1N1 and seasonal influenza shots, medical experts say.

Past influenza pandemics have proved that they're at increased risk for severe complications and they appear to be even more vulnerable to this new flu strain, the Los Angeles Times reports.

On Thursday, a consortium of major medical groups, including the American Medical Assn., the Centers for Disease Control and Prevention, and the American College of Obstetricians and Gynecologists, released a statement urging pregnant women to get both the H1N1 and seasonal flu vaccines.

Vaccinations

There is the worry about pregnant women, as previously it has seemed that they have an aversion towards vaccinations. Only 15 percent get the flu vaccine in any given year, compared with 30 percent of the general population, CDC reports.

The current shortage of the H1N1 vaccine may create a further obstacle against efforts at widespread immunization. Moreover, pregnant women distrust medications in general, even though flu vaccines could prevent or mitigate infection should they be exposed.

"We may have to hospitalize more pregnant women than we ever have before," said Dr. Allison Bryant, an assistant professor of obstetrics, gynecology and reproductive health at UC San Francisco, who has studied the current pandemic's effects on pregnant patients.

Swine flu deaths

By 21 August, the latest date for which numbers are available, pregnant women accounted for 6 percent of the 484 confirmed US deaths linked to what's known as swine flu. Two H1N1-related deaths in pregnant women have been reported in Los Angeles County, according to the county Department of Public Health.

Of the 700 cases of pregnant women diagnosed with flu reported to the CDC, 14 percent required admission to an intensive care unit -- four times the hospitalization rate of non-pregnant women of similar age. That number is probably an underestimate, CDC officials said, because many cases aren't confirmed by testing.

Many pregnant women are teenagers or young adults - among the groups most likely to develop severe cases of influenza.

"These otherwise healthy pregnant women can deteriorate rapidly," said Dr. Denise Jamieson, a medical officer in the CDC's division of reproductive health. "We have seen some cases where pregnant women present in the emergency room, and they are already so sick they are incubated and delivered very quickly."

Options

Pregnant women have two options for protections this year - the H1N1 vaccine, for which they, and young children have been given priority, and the antiviral medicationTamiflu.

"We usually say pregnant women should only take medications for which the benefits outweigh the risks," Bryant said. "But we certainly believe that is the case with H1N1."

Flu, in general, causes more complications in pregnancy because a woman's immune system is naturally weakened to prevent her body from rejecting the fetus. That boosts the chances of secondary infections, such as pneumonia.

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