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Why Vaccines in Pregnancy?

I know many of the women I work with are opposed to vaccines.  So I have decided it is necessary for me to have the best understanding possible so I know when to definitely recommend a vaccine, when to definitely recommend against, and how to help the parents understand the risks and benefits.

The first thing I often hear is that women want nothing to do with a vaccine in pregnancy, fearing it is unsafe for the baby.  This often comes up with the influenza vaccine.  CDC guidelines are clear that pregnant women should get the vaccine, but do you know why they recommend that?

1.  The recommendation is for the attenuated vaccine, not a live vaccine. This means the virus is not able to make you sick, but is still able to be recognized by your immune system to allow you to create a defense against the strains.

2. The defense you create to the influenza virus is transferred to your baby. These cells stay in your babies blood for about 6 months, meaning your baby is protected against influenza without having to get a shot.

3. When pregnant women contract influenza, they tend to be sicker than non-pregnant women. You cannot assume getting influenza in pregnancy is like getting a cold before you were pregnant.

4. Public health is about preventing disease, because the theory is if you prevent it then you do not have to deal with the problems the disease causes.

So these are the basic reasons CDC recommends pregnant women get an influenza vaccine. In terms of safety profile, the influenza vaccine has a pretty good one.  Even with H1N1, the basics of the vaccine stay the same it is the strain of virus that changes.  A group of virologists look at the strains of influenza present, then look at history to try to figure out what strain will be big next.  Some years they get it right, others (like 2009 with H1N1) they guess wrong and the major virus is not included in the vaccine.

I’m a vaccine cautious person, so what do I do?  While in school my choice is made for me, get the shot or no clinical.  But in reality I would choose to have the influenza vaccine while in school anyway.  Why?  Because in a health care office and in the hospital I am more likely than the general population to come into contact with the viruses.  If I get the virus, I will bring it home to my children and husband before I know I have it.  My children, though not asthmatic, have an unexplained asthma-like wheezy response to lower respiratory illnesses (perhaps due to my family history of allergies and asthma?).  It is my desire to reduce the number of these illnesses for my children to help prevent any asthma-like remodeling of their lungs.

Your decision may be different.  I’m sure if I didn’t have the children to think about, I might consider the value of the vaccine differently – but not being able to be in that situation I don’t know how my answer would come out.

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Jennifer Vanderlaan CNM MPH is the author of the BirthingNaturally.net website. She has been working with expectant families since 2000, training doulas, childbirth educators, and midwives. She has worked with midwives in Central America and Sub-Saharan Africa. Her interest in public health grew in 2010, and she is now a PhD student learning to become a producer of knowledge.

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