Pregnant women unsure about getting H1N1 flu shot, shows new survey

Oct 24 2009

Despite majorities expressing concern about getting the novel H1N1 (or swine) flu this year, only about one in four pregnant women or new mothers plan to get the H1N1 flu shot, according to findings from a new survey conducted on behalf of HealthyWomen by Harris Interactive. The survey of pregnant women and new mothers also revealed that 43 percent of women plan to get the seasonal flu shot this year, up from 33 percent surveyed last year. Moreover, Hispanic women surveyed showed that they are more likely than women overall to be concerned for themselves and their children getting H1N1 and seasonal flu, but are less aware of expert recommendations that pregnant women get both flu shots this year to protect themselves and their newborns.

To address women's concerns and the information gap on flu vaccination during pregnancy, HealthyWomen and the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) are continuing their "Flu-Free and A Mom-to-Be: Protect Yourself, Protect Your Baby -- Get Your Flu Shots!" program. The campaign, supported by CSL Biotherapies, educates pregnant women and their healthcare providers on the need to make flu vaccination for both the seasonal and H1N1 viruses an essential part of prenatal care. This is critical as data from the Centers for Disease Control and Prevention (CDC) shows that only 24 percent of pregnant women received a flu shot last season.

"These survey results show the urgent need to educate pregnant women on the facts, benefits and safety of getting both the seasonal and H1N1 flu shots," said Elizabeth Battaglino Cahill, RN, executive director of HealthyWomen. "The 'Flu-Free and A Mom-to-Be' campaign will advance the discussion with new moms and moms-to-be on the importance of getting the flu shots while pregnant to protect themselves and their newborns." Campaign materials are available in both English and Spanish.

The survey of 668 pregnant women or new mothers, 154 of whom are Hispanic, showed that only half of women (50%) know that getting a flu shot while pregnant will protect themselves and their newborn babies after birth. However, Hispanic women are more likely to believe the false claim that getting a flu shot while pregnant can put a woman's unborn baby's health at risk (41% vs. 26% of all women). Moreover, less than half of Hispanic women (49%) are aware that the seasonal and H1N1 flu shots are recommended for pregnant women, compared to 71 percent of women overall.

Pregnant women are a priority audience for flu vaccination because they are at higher risk of hospitalization for complications from the flu due to physiologic changes associated with pregnancy, such as an increase in heart rate, reduction in lung capacity and changes in immune responses. In fact, a recent study found that during the first month of the H1N1 outbreak (April 15 to May 18, 2009), hospitalization rates for H1N1 flu were four times higher in pregnant women than in the general population. The CDC, the American College of Obstetrics and Gynecology (ACOG), AWHONN and numerous other professional women's health and obstetrics organizations strongly urge all new moms and moms-to-be to get the flu shots to protect themselves and their newborns through passed immunity. A 2008 New England Journal study showed that babies of mothers vaccinated against the flu during pregnancy experienced a 63 percent reduction in influenza illness due to passed immunity from mom to baby. Newborns under six months of age are extremely vulnerable to influenza infection and its dangerous consequences, but cannot get vaccinated.

"With H1N1 being the dominant influenza virus circulating so far this year, it is vital that all pregnant women get their seasonal and H1N1 flu shots as soon as possible," said Ashley Roman, MD, clinical assistant professor of obstetrics and gynecology at New York University School of Medicine and assistant clinical professor at Yale University. "Both the seasonal and H1N1 flu shots are safe for women to get during any stage of pregnancy and the shots are available in thimerosal-free forms, for those who are concerned about mercury preservatives."

While 86 percent of women believe that the seasonal flu shot is safe, only 68 percent think the H1N1 flu shot is safe, revealed survey data. The main concern among pregnant women about getting the H1N1 flu shot is the belief that the vaccine has not been adequately tested (43 percent among pregnant women not planning to get the H1N1 flu shot). The H1N1 vaccine, which is made the same way as the seasonal flu shot, has been found in clinical studies to be safe and effective at producing an immune response in healthy adults.

"It is important that all healthcare providers be vigilant about initiating conversations with their pregnant patients about the benefits of getting the flu shots and their safety, especially as recent survey data show that the majority of pregnant women are more likely to get the flu shots if recommended by their healthcare provider," said Catherine Ruhl, CNM, MS, director of women's health programs at AWHONN.

Hispanic Women More Proactive About Discussing Flu Shots

More Hispanic women discussed the H1N1 and seasonal flu shots with their healthcare providers than women overall. In fact, 50 percent of Hispanic women have discussed H1N1 flu shots with their healthcare providers compared to only 21 percent of women overall. Similarly, more Hispanic women have discussed the seasonal flu shot with their healthcare providers than women overall (61 percent vs. 56 percent).

The presence of thimerosal in flu vaccines is of particular concern to more than half of Hispanic women surveyed. However, nearly two-thirds (64%) are not aware or not sure only that mercury-free flu vaccines are available. Of the Hispanic women who discussed either the seasonal flu shot or H1N1 flu shot with their healthcare provider, the majority discussed the availability of thimerosal-free flu vaccines with their healthcare providers (77 percent discussed H1N1; 59 percent discussed seasonal).

"These survey results show that getting the seasonal and H1N1 flu is of particular concern to Hispanic women, but that there is confusion about the benefits of vaccination during pregnancy to mother and baby," said Diana Ramos, MD, MPH, FACOG, associate clinical professor of obstetrics and gynecology at the Keck University of Southern California School of Medicine. "Educating Hispanic families on the need for flu vaccination during pregnancy is the first step in protecting pregnant women and their newborns."

The "Flu Free and A Mom-to-Be" campaign was launched last year and received the 2009 National Influenza Vaccine Summit Excellence Award. This year's program includes information on the newly emerged H1N1 virus and vaccine, in both English and Spanish. The aim of the program is to educate pregnant women on the flu and urge them to discuss getting the flu shots with their healthcare providers. The campaign's educational tools and materials include online content addressing common myths with facts on influenza and pregnancy; tips on obtaining the flu shots while pregnant; information on types of flu vaccines available; and a flu tip card and poster for healthcare provider offices and clinics, which can be viewed at www.HealthyWomen.org/flufree. Support of the "Flu-Free and a Mom-to-Be" campaign reflects CSL Biotherapies' ongoing commitment to raising awareness of influenza vaccination among priority populations.