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2009 H1N1 Influenza Shots and Pregnant Women


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Why does CDC advise pregnant women to receive the 2009 H1N1 influenza (flu) vaccine (shot)?

Gettingthe flu shot is the single best way to protect against the flu. It isimportant for a pregnant woman to receive both the 2009 H1N1 flu shotand the seasonal flu shot. A pregnant woman who gets any type of fluhas a greater chance for serious health problems. Compared with peoplein general who get 2009 H1N1 flu (formerly called “swine flu”),pregnant women with 2009 H1N1 flu are more likely to be admitted tohospitals. Pregnant women are also more likely to have serious illnessand death from 2009 H1N1 flu. When a pregnant woman gets a flu shot, itcan protect both her and her baby. Research has found that pregnantwomen who had a flu shot get sick less often with the flu than dopregnant women who did not get a flu shot. Babies born to mothers whohad a flu shot in pregnancy also get sick with flu less often than dobabies whose mothers did not get a flu shot.



Will the seasonal flu shot also protect against the 2009 H1N1 flu?

Seasonalflu and 2009 H1N1 flu are caused by different viruses. The seasonal fluvaccine will not protect against the 2009 H1N1 flu. Also, the 2009 H1N1flu vaccine will not protect against seasonal flu.



Are there flu vaccines that pregnant women should not get?

Theseasonal and 2009 H1N1 flu vaccines can be given by shot or by nasalspray. Pregnant women should get the "flu shot"—a vaccine made withkilled flu virus. This one is given with a needle, usually in the arm.The other type of flu vaccine—a nasal spray—is not approved forpregnant women. This vaccine is made with live, weakened flu virus.Nasal spray flu vaccine should be used only in healthy people 2-49years of age who are not pregnant. The nasal spray vaccine is safe forwomen after they have delivered, even if they are nursing.



Can the seasonal flu shot and the 2009 H1N1 flu shot be given at the same time?

Seasonaland 2009 H1N1 flu shots can be given on the same day but should begiven at different sites (e.g., one shot in the left arm and the othershot in the right arm). If a woman is getting her vaccines afterdelivery, she can get the nasal spray flu vaccine. However, she shouldnot get the seasonal and 2009 H1N1 nasal spays on the same day; theyshould be given 4 weeks apart.



Is the 2009 H1N1 flu shot safe for pregnant women?

Theseasonal flu shot has been given to millions of pregnant women overmany years. Flu shots have not been shown to cause harm to pregnantwomen or their babies. The 2009 H1N1 flu vaccine is being made in thesame way and at the same places where the seasonal flu vaccine is made.



What studies have been done on the 2009 H1N1 flu shots and have any been done in pregnant women?

Studiesto test the 2009 H1N1 flu shots in healthy children and adults andpregnant women are being done now. Results are available from some ofthe studies done in non-pregnant adults and children. These resultsshow that the immune system responded well to the 2009 H1N1 vaccine,and the safety results were very similar to those seen in studies ofseasonal flu vaccine. These studies are being conducted by the NationalInstitute of Allergy and Infectious Diseases (NIAID) and the vaccinemanufacturers. More information can be found at





Does the 2009 H1N1 flu shot have mercury in it?

Thereis no evidence that thimerosal (a mercury preservative in vaccine thatcomes in multi-dose vials) is harmful to a pregnant woman or a fetus.However, because some women are concerned about thimerosal duringpregnancy, vaccine companies are making preservative-free seasonal fluvaccine and 2009 H1N1 flu vaccine in single-dose syringes for pregnantwomen and small children. CDC advises pregnant women to get flu shotseither with or without thimerosal.



Does the 2009 H1N1 flu shot have an adjuvant or squalene in it?

Adjuvantsare agents that are sometimes added to a vaccine to make it moreeffective. There are no adjuvants (such as squalene) in either the 2009H1N1 or seasonal flu shot used in the United States.



Can the 2009 H1N1 flu shot be given at any time during pregnancy?

Both seasonal flu shots and 2009 H1N1 flu shots are recommended for pregnant women at any time during pregnancy.



How many 2009 H1N1 flu shots will a pregnant woman need to get?

TheU.S. Food and Drug Administration (FDA) has approved the use of oneshot for full protection for persons 10 years and older. Therefore, apregnant woman is recommended to get one dose of the 2009 H1N1 vaccine.



Should the 2009 H1N1 flu shot be given to apregnant woman who had flu between April 2009 and now? Do I need a testto know if I need the shot or not?

A pregnantwoman who had a flu-like illness at any time in the past should stillget the 2009 H1N1 shot because she cannot assume that the illness shehad was caused by the 2009 H1N1 virus. Pregnant women who had flusymptoms in the past do not need to be tested now, but should get thevaccine.



What are the possible side effects of the 2009 H1N1 flu shots?

Theside effects from 2009 H1N1 flu shots are expected to be like thosefrom seasonal flu shots. The most common side effects after flu shotsare mild, such as being sore and tender and/or red and swollen wherethe shot was given. Some people might have headache, muscle aches,fever, and nausea or feel tired. If these problems happen, they usuallybegin soon after the shot and may last as long as 1-2 days. Some peoplemay faint after getting any shot. Sometimes, flu shots can causeserious problems like severe allergic reactions. But, life-threateningallergic reactions to vaccines are very rare. A person who has a severe(life-threatening) allergy to eggs or to anything else in the vaccineshould not get the shot, even if she is pregnant. Pregnant women shouldtell the person giving the shots if they have any severe allergies orif they have ever had a severe allergic reaction following a flu shot.



Is the 2009 H1N1 flu shot expected to be associated with Guillain-Barre Syndrome (GBS)?

In1976, an earlier type of swine flu vaccine was associated with cases ofa severe paralytic illness called Guillain-Barre Syndrome (GBS) at arate of approximately 1 case of GBS per 100,000 persons vaccinated.Some studies done since 1976 have shown a small risk of GBS in personswho received the seasonal influenza vaccine. This risk is estimated tobe no more than 1 case of GBS per 1 million persons vaccinated. Otherstudies have shown no increase in risk of GBS. Pregnant women shouldtell the person giving the shots if they have ever had GBS.



Can family members or other close contacts of a pregnant woman receive the nasal spray vaccine?

Pregnantwomen should not receive nasal spray for the seasonal or 2009 H1N1 fluvaccine, but it is okay for a pregnant woman to be around a familymember or another close contact who has received nasal spray fluvaccine. The nasal spray vaccine can be used in healthy people 2-49years of age who are not pregnant and in women after they deliver, evenif they are nursing.



Can a pregnant healthcare provider give the live nasal spray flu vaccine?

Yes.No special precautions are needed. Nurses and doctors should wash theirhands or use an alcohol-based hand rub before and after giving thevaccine.



What if a pregnant woman gets the live nasal spray flu vaccine instead of the flu shot?

Thenasal spray flu vaccine has not been approved for pregnant women. Itdiffers from the flu shot because it is made with live, weakened virus.However, sometimes a pregnant woman might get the nasal spray fluvaccine—for example, before she knew she was pregnant. If thishappened, she would not be expected to have any additional problems.The weakened, live flu virus has never been shown to be passed to theunborn baby. However, if a woman does get the nasal spray vaccine whileshe is pregnant, she should talk to her healthcare provider.



Ifa pregnant woman delivers her baby before receiving her seasonal flushot or her 2009 H1N1 flu shot, should she still receive them?

Yes.Besides protecting her from infection, the shot may also help protecther infant. Flu shots are only given to infants 6 months of age andolder. Everyone who lives with or gives care to an infant less than 6months of age should get both the seasonal flu and 2009 H1N1 vaccines.A woman can get either the shots or the nasal spray after she delivers.



Can a breastfeeding mother receive the flu shot or the nasal spray?

Yes.Both seasonal and 2009 H1N1 flu vaccines should be given tobreastfeeding mothers and breastfeeding women can receive either theshot or the nasal spray form of the vaccine. Breastfeeding is fullycompatible with flu vaccination, and preventing the flu in mothers canreduce the chance that the infant will get the flu. Also, bybreastfeeding, mothers can pass on to the infant the antibodies thattheir bodies make in response to the flu shots, which can reduce theinfant’s chances of getting sick with the flu. This is especiallyimportant for infants less than 6 months old, who have no other way ofreceiving vaccine antibodies, since they are too young to be vaccinated.


Talk to your doctor or visit http://www.flu.gov/ or http://www.cdc.gov/h1n1flu/pregnancy/ to learn more.



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It is possible that a physician meeting with the first case of a certain epidemic, should fail to perceive at once it perfect image, because every collective virus of this kind will not manifest the totality of its symptoms and character, until many cases have been observed. But, once the physician is accustomed to exact observation, my approach the true condition of the epidemic so closely, that he/she is enabled to construe a characteristic image of the same, and even discover the appropriate medicinal remedy.

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