My patients are smart, open-minded women. They don't take decisions about their health lightly, yet I am surprised by the number of pregnant women I know who get a flu vaccine without a second thought.
Pharmaceutical companies and doctors are pushing hard for the flu shot during pregnancy. Why? Is this protection necessary?
I've written before about why not to get a flu shot, but the concerns are different for expectant mamas.
What your doctor will probably tell you about the flu shot during pregnancy
- Flu shots have not been shown to cause harm to mom or baby in any trimester.
- Pregnant women are more susceptible to the flu and to serious complications of flu, like pneumonia.
- Getting the flu during pregnancy poses a serious risk to your baby. High fevers in the first trimester have been associated with an increased rate of birth defects. Flu during pregnancy appears to increase the risks of miscarriage, premature birth, and low birth weight.
- Babies are at high risk of complications from the flu, but cannot get vaccinated until they are 6 months old. Babies born to pregnant women who have received the flu shot are less likely to develop flu and related complications.
I don't fault my pregnant patients for choosing to get a flu shot, and I even understand that their doctors think they are providing sound advice.
I do, however, believe there is an urgent need for education around the flu shot during pregnancy, and that we need to take pause before we mass-inoculate our childbearing women against a largely harmless illness.
The truth about the flu shot during pregnancy
We actually do not know if the flu shot during pregnancy is safe.
The American College of Obstetricians and Gynecologists states that “no study to date has seen an adverse consequence of influenza vaccine in pregnant women and their offspring.” Well, my friends, this is because there hasn't been much research to determine its safety. (source)
In fact, the warnings on the inserts of flu vaccines clearly state that “safety and effectiveness have not been established in pregnant women or nursing mothers,” yet the shot is routinely administered to these very women for the protection of their pregnancies.
What's more, a recent found that the flu vaccine is linked to an increased risk of miscarriage.
What we do know about the flu vaccine is that it's packed with toxic ingredients like aluminum, polysorbate-80, formaldehyde – and if you don't go out of your way to be sure – mercury, a known neurotoxin to babies and mothers alike.
As I explored in this post about the tetanus shot, the toxic substances in vaccines unnecessarily raise your body's antibody titer (the number of good guys fighting the bad). This in turn can create an autoimmune response where the body is actually weakened from the vaccine, leading to more susceptibility to infection and chronic illness.
There are also known long-term health risks to getting flu shots including serious health conditions such as Guillain-Barré Syndrome, vascular disorders, and narcolepsy.
With little actual clinical research proving that a flu shot during pregnancy is safe and some indication that it's not great for any human (pregnant or not), why is there such a push for this kind of ‘preventative' care?
The flu shot is not that effective
When pharmaceutical companies develop a new flu shot each year, they have to guess at which three of out of hundreds of potential strains will be most likely to infect the population.
That's right: guess.
This is usually based on the strains that have affected other global populations in their most recent flu seasons. A fair guess, but often inaccurate: In 2012-13, the flu vaccine was overall 56% effective (and as low as 9% for the elderly population that most needed it). In 2011-12 the efficacy rate was 47%. (source)
In pregnant women, flu-related complications occur at the same rate whether vaccinated and unvaccinated – not a great selling point for the flu shot's efficacy. (source) Two studies of vaccine safety during pregnancy found that there were many more cases of hospitalization due to influenza-like illness among women who were vaccinated than of women who weren’t. (source)
Flu during pregnancy is not usually a disaster for mom or baby
Let's face it, having the flu is awful, and having the flu during pregnancy is especially miserable.
But the fact of the matter is that for most folks – including pregnant women – the flu is just an extremely uncomfortable, inconvenient event.
The numbers of how many people have serious influenza-related complications are blown out of proportion. According to the well-known pediatrician, Robert Sears, MD, even though millions of people come down with the flu every year, “virtually all cases of the flu pass without consequence.”
By nature, pregnancy puts extra stress on the mother’s body, and while her ability to fight infections might be compromised, overwhelming data suggests that this is the exception, not the rule.
Data suggests that out of every 10,000 pregnant women only 25 (0.25%) are even hospitalized with serious complications due to influenza and these statistic apparently also includes women who are also admitted for unrelated pneumonia. Pre-existing conditions such as asthma or obesity are often underlying factors in these rare cases.
The largest scientific study to date included 49,585 pregnant women who were part of the Kaiser Permanente healthcare organization in Northern California over five flu seasons, as well as 48,639 live births among the same pool during the same time period. The researchers concluded that, ‘Hospital admission with a principal diagnosis of influenza or pneumonia was an extremely rare event for the women in the study population.' Only nine women (out of almost 50,000) were admitted, which is 0.018 percent, or less than one in 5,000; and of those nine women, all had pneumonia. All nine women recovered with no complications. (source)
Regarding the claim that flu increases risks to the fetus, this report in the Journal of American Physicians and Surgeons concluded that true flu infection had no significant impact on labor outcomes, health of the newborn, or maternal well-being, and recommends that the CDC should withdraw their recommendation to recommend the flu shot during pregnancy.
Holistic measures can better protect you and your baby
One thing your doctor and I can certainly agree upon is that we don't want your newborn to get the flu.
Luckily there are safe and effective measures to take that are far more effective than flu shots.
How to protect against the flu for mom and baby
Avoiding cold and flu when you have a newborn in the house should be taken very seriously whether or not you choose to get a flu shot during pregnancy.
If you have small children that are heading off to school or daycare, it may be inevitable that sick germs penetrate your home. Do you best to teach hand washing, prevent your children from touching or sneezing on your baby, and load your older children with immune boosters. Enforce a strict policy that guests may not visit if they are any version of sick (this includes feeling a bit off or being ‘in recovery').
Making them wait to hold your bundle of joy is better than them infecting your newborn with the plague.
Strengthen your immune system
Aside from commonsense measures, the key to defending against the flu (for any human) is to build a strong immune system.
Sure, you may still get sick, but if your body is well-rested, nourished and healthy, your symptoms are likely to be less severe and it will be less likely that your cold or flu will advance into life-threatening pneumonia.
While babies are born with immature immune systems, breastfed babies are blessed with a shared immunity with their mothers and are less likely to get sick than their bottle-fed peers.
Maintain healthy Vitamin D levels
Mounting research shows that vitamin D is an essential nutrient for immune health. Despite living in sunny Southern California, I find that many (if not most) of my patients have inadequate vitamin D levels when checked with a blood test.
Many doctors follow outdated recommendations, and the vitamin D council recommends that vitamin D blood levels of 60-90 ng/ml can reduce your risk of infection and cut down on the duration of illness if you do get sick. (source) Ask your obstetrician or midwife for your specific level – a number – rather than accepting when he or she tells you that your level is ‘fine'.
In my family we try to get plenty of sunshine so that our bodies can naturally produce vitamin D. But even in our climate, in the winter it can be hard to get enough. For most people in the Northern Hemisphere, a supplement is the best way to build up your immunity, and there are many delicious food sources for getting enough vitamin D as well.
Read more about raising your vitamin D levels in this post.
Use other natural remedies
If your baby does get sick despite your best efforts (shot or not), don't panic. Make sure to keep him/her hydrated with plenty of breast milk, and be sure to consult with both your pediatrician and holistic health practitioner to get a balanced perspective of professional advice.
If it's not safe, necessary, or effective – WHY would you opt for a flu shot during pregnancy?
Brogan, Kelly. “Rejecting Flu Vaccine In Pregnancy.“
Ayoub, David M., MD, and F. Edward Yazbak, MD, “Influenza Vaccination During Pregnancy: A Critical Assessment of the Recommendations of the Advisory Committee on Immunization Practices (ACIP),” Journal of American Physicians and Surgeons 11, no. 2 (Summer 2006): 41.
Margulis, J. What the Doctor Isn’t Telling You about Pregnancy and the Flu Vaccine. Dec 07, 2011v.