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H1N1 Vaccine A Tough
Sell To Pregnant Women

As the H1N1 influenza vaccine trickles into clinics and pharmacies over the next few weeks, public health officials and doctors desperately hope that pregnant women will be at the front of the line for the shot.

A consortium of major medical groups, including the American Medical Assn., the Centers for Disease Control and Prevention, and the American College of Obstetricians and Gynecologists, released a statement pleading with pregnant women to get both the H1N1 and seasonal flu vaccines.

But pregnant women have a well-established antipathy toward vaccinations, with only 15% getting the flu vaccine in any given year, compared with 30% of the general population, according to CDC reports. The current shortage of the H1N1 vaccine may further stymie efforts at widespread immunization. Moreover, pregnant women distrust medications in general -- even though conventional medicine insists that flu vaccines could prevent or mitigate infection should they be exposed.

"Pregnant women have an incredibly strong matenal instinct and they will not submit their child to anything that could even possibly be of harm," said midwife Naomi Kates.

All of these factors indicate doctors' hopes will go unrealized even as rates of flu-related deaths, hospitalizations and preterm births rise.

"We usually say pregnant women should only take medications for which the benefits outweigh the risks," Bryant said.

Flu, in general, causes more complications in pregnancy because a woman's immune system is naturally weakened to prevent her body from rejecting the fetus. That boosts the chances of secondary infections, such as pneumonia.

Flu is not thought to be transmitted to the fetus, but the infection's indirect effects, such as high fever, can increase the risk of neural tube defects.

Yet a sizable portion of reproductive-age women in Los Angeles are not convinced of the value of any type of vaccine, said Dr. James Moran, chairman of obstetrics and gynecology at Saint John's Health Center in Santa Monica.

It may be harder to persuade pregnant women to take Tamiflu. Until this year, the drug was not recommended for pregnant women because its effects on the fetus are relatively unknown.

Not usually enthusiastic about recommending drugs for pregnant women, the CDC has taken a drastic step based on pressure from health agencies to nonetheless recommend that pregnant women.

* A full list of h1n1 vaccine ingredients, alerts and warnings.

Reference Source 130
October 23, 2009


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