Doctors urging pregnant women to get H1N1 vaccine

Saturday, October 31, 2009 | 12:01 a.m. CDT; updated 8:53 p.m. CDT, Saturday, October 31, 2009

COLUMBIA — Shatenita Horton is due to give birth in the coming week. In spite of the contact she had with the public on her job as assistant vice president of business banking at Boone County National Bank, she chose not to get any flu shots.

She's never had the shot before, and she's never had the flu, she said, though she does take precautions like using hand sanitizer and avoiding close contact with people.

Vaccine at the health department

The Columbia/Boone County Department of Health and Human Services is now offering the H1N1 vaccine to women who are pregnant. The vaccine is given free of charge, and is available on a walk-in basis Monday through Friday from 8 a.m. until 4:30 p.m.

She talked to her doctor when she was deciding about getting a shot. “It was a big thing," she said. "I talked to her, and kind of just said, what do you suggest? She didn’t force me one way or the other.”

Her doctor told her the vaccine was highly recommended. “She gave me all the information I needed, and just said, ‘It’s totally up to you,’” Horton said.

H1N1 is more dangerous for pregnant women than the seasonal flu. It has a unique combination of antigens, which can lead to prolonged illness, hospitalization, and other serious problems, said Dr. Randall Floyd, director of the department of obstetrics, gynecology and women’s health at the Missouri Center for Maternal-Fetal Medicine and Ultrasound.

According to the Centers for Disease Control and Prevention, almost 600 deaths due to H1N1 had been reported as of August 2009. Of 100 pregnant women hospitalized with H1N1, 28 have died.

Although there has been controversy about the preservative in the vaccine, Missouri lifted its ban on the use of the preservative in pregnant women and young children. The vaccine does not have any known negative side effects.

“We are very strongly convinced that the risk of the vaccine is far less than the risk of the disease,” Floyd said. “It’s the same type of vaccine that’s been around for 40 years. The risk of taking the H1N1 vaccine is the same as any flu shot.”

That's why Floyd is making a pretty strong case for getting the shot when he talks to  expectant mothers. “I try to get everyone who comes to my clinic to get the vaccine,” Floyd said.

The immune system of a woman who is pregnant must tolerate a fetus that is only partially her genetic makeup, Floyd said. This causes the mother’s immune system to undergo changes, which can make her more susceptible to illness.

A severe flu illness can have dangerous effects on the unborn child. Hypoxia, which is a lack of oxygen, in the mother means a lack of oxygen for the child. A high fever can hinder the development of a child’s nervous system. “The baby is going to get the virus if the mom does,” Floyd said.

That's also the opinion of the CDC, which said in a letter distributed to health practitioners that “the safety of the 2009 H1N1 monovalent vaccine is expected to be similar to the season influenza vaccine, which as been given to millions of pregnant women.”

Floyd added that the seasonal flu shot might or might not be effective in any given flu season, depending on the strain of flu each season. Last year, he said, the seasonal flu covered only about 40 percent of the strains people were exposed to.

“This year they’ve actually done a good job,” with the seasonal vaccine being 70-80 percent effective, Floyd said. “The H1N1 vaccine is close to 100 percent effective.”

Last week Missouri temporarily suspended a ban on the vaccine version that contained the preservative thimerosal for pregnant women and young children. Missouri was one of three states that had such a ban, and all three have waived it for the H1N1 vaccine.

“Thimerosal is a very effective preservative that has been used since the 1930’s to prevent contamination in some multi-dose vials of vaccines,” according to the CDC. “There is no convincing evidence of harm caused by the low doses of thimerosal in vaccines, except for minor reactions like redness and swelling at the injection site.”

Tedra Kelley knows all about the research. A senior credit administrative representative and Horton’s friend and co-worker, Kelley has already had both the seasonal and H1N1 shots. She's 31 weeks pregnant and is due December 30.

“I did a lot of research on it, and I didn’t really find anything that told me that I shouldn’t,” Kelley said. “I felt that the risks of swine flu are worse than the shot."


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