Pregnant? Get A Flu Shot _ But It May Be A Hassle
While federal health officials are working hard to raise that number this year, repeated swine flu warnings wont automatically overcome a key obstacle: Many obstetricians dont vaccinate. And not only are many women reluctant to go hunting for flu shots elsewhere, historically some pharmacists and other providers have been wary of vaccinating them.
“Maybe this year we can change that culture,” says Dr. Anne Schuchat of the Centers for Disease Control and Prevention. “Its not supposed to happen that you, when you are pregnant, are fighting for your life on a respirator.”
Yet getting simple vaccine information took Charla Bason of Washington, D.C., repeated requests, as she was bounced between her obstetricians office and her primary care doctor a few weeks ago.
“I feel like if I hadnt brought it up, they never would have mentioned it to me,” says Bason, 30, who is seven months pregnant with her first child.
Bason decided to seek vaccination after watching a CDC Webcast about pregnant women and talking with a physician in the family. But she still has no clear answer about where to get one.
“Its been incredibly frustrating. Theres a terrible disconnect between the message that was getting out and, once you decide you want it, how do you get it?” she says.
Any kind of flu is risky during pregnancy, and pregnant women have been on the get-a-flu-shot priority list for years. Their reluctance to take any medication during pregnancy is part of the reason for the low vaccination rates.
With swine flu, what doctors call the 2009 H1N1 strain, pregnant women seem at particular risk for complications. Pregnant women make up 6 percent of H1N1-confirmed deaths even though they account for only 1 percent of the population, according to the CDC. Theyre at least four times as likely to be hospitalized as other flu sufferers.
Vaccine is a two-for-one deal during pregnancy: It can protect not just mom but the baby, too, for the first few months after birth. The mothers body makes flu-fighting antibodies that easily cross the placenta to be carried by the fetus, explains Dr. Neil Silverman of the University of California, Los Angeles. Thats important because flu can easily kill newborns, yet babies cant be vaccinated until theyre 6 months old.
Once women get that vaccine advice, where do they get the shot?
The American College of Obstetricians and Gynecologists has no count of how many OBs offer flu vaccine. Its still considered a minority although recent surveys suggest many more may be starting this year, especially in large cities.
An extra complication: Each states health department ultimately will decide who gets to offer the H1N1 vaccine, aiming for locations that vaccinate the most people. Those decisions havent been made public yet. Even if your OB requested swine flu shots, he or she may not get any, at least from initial shipments.
Yet providers who dont routinely treat pregnant women may not understand flus risk and the shots safety record, says Silverman, who helps set ACOG practice guidelines.
Take pharmacists, expected to be key H1N1 vaccinators. Silverman gets occasional phone calls from women who say a pharmacist wont fill the flu-shot prescription he wrote.
“They act like the doctor who prescribed it didnt know what he or she was doing,” says Silverman, who settles the standoff by getting the pharmacist on the phone. For every patient who calls, “I know there are at least two who just say, Well, OK, Im not going to do this, and just walk away.”
The American Pharmacists Association is urging its members to follow the CDCs pregnancy guidelines but cant mandate that, and a few stores may still balk, says association chief of staff Mitchel Rothholz.
But some are embracing the potential customers. The large Walgreens drugstore chain told states that if picked as an H1N1 shot site, it might put get-vaccinated-here signs next to the pregnancy tests, or print vaccine reminders for people who bought prenatal vitamins.