Recent investigations have revealed that the number of US children under two who have not received critical vaccines that protect against preventable diseases has quadrupled since 2001. In Europe, distrust or disinterest in vaccines has led to similar – if not worse – rates of immunization, the direct result of which has been several unprecedented measles outbreaks. The statistics on flu shots is equally sobering; estimates from the previous season put US coverage at about 36 to 53 percent, with regional variation. In the UK, nearly 49 percent of those aged 6 months to 65 years and almost 73 percent of those 65 and above received flu shots.
And now, according to research by the Centers for Disease Control and Prevention (CDC), a worrying number of pregnant women are also forgoing important vaccinations.
“Findings from this survey indicate that many pregnant women are unvaccinated, and they and their babies continue to be vulnerable to influenza and pertussis infection and potentially serious complications including hospitalization and death,” an agency team wrote in the September 28 Morbidity and Mortality Weekly Report.
Their data was gathered from an Internet survey, conducted between March 28-April 10, 2018, of 1,771 women who were pregnant during the peak influenza vaccination period (October 2017-January 2018). The survey’s inclusion criteria were designed to create a group of diverse participants that could represent pregnant women and new mothers throughout the country.
Among all subjects, only 49.1 percent stated that they received an influenza vaccine before or during their pregnancy. Among the 700 subjects who had been in the correct phase of their pregnancy to receive a Tdap vaccine – a combined vaccine against Tetanus, Diptheria, and Pertussis – during the study’s time window, only 54.4 percent had done so. Of these 700, 32.8 percent said they received both vaccines during their pregnancy.
Currently, the CDC recommends that all women who are or might be pregnant during the influenza season should get vaccinated, and they may do so safely at any time during their pregnancy. Women should get the Tdap during each pregnancy, preferably from 27 through 36 weeks’ gestation.
As to why they did not receive the vaccines, 20.2 percent of women who passed on the flu shot cited believing it is not effective, and 45.1 percent of those without the Tdap claimed to not know they needed to be vaccinated during every pregnancy. The second most commonly reported reason for nonreceipt was concern about safety risks to the baby (16 and 13.5 percent of women who forwent the influenza vaccine and Tdap, respectively.)
The evidence backing the safety and illness prevention efficacy of Tdap and flu vaccines for pregnant women and their babies is irrefutable. No vaccine can extend perfect coverage from an infectious agent, but they can reduce the likelihood of disease by upwards of 98 percent. And even seasonal flu vaccines that aren’t a high match for that year’s dominant strains often still extend a reassuring degree of protection. Conferring flu protection through maternal vaccination is especially important, as there are no versions of the vaccine approved for direct immunization of babies less than six months old; newborns to six-month-olds are at high risk of severe flu due to their still-developing immune systems. The first of the Tdap vaccines series may be given at two months.
In line with past studies, the report also found that women who were offered vaccines by their healthcare provider were most likely to get them. Though it seems obvious that physicians would emphasize the importance of vaccines, the suboptimal rates of coverage imply that some patients are falling through the cracks in terms of follow-up. Doctors need to step up their game and pregnant women need to advocate for the health of their family more strongly.