More Pregnant Women Need Encouragement for Flu, Tdap Shots, CDC Says

Kerry Dooley Young

October 08, 2019

Pregnant women need more encouragement to get influenza and pertussis vaccines, as many of them are missing these recommended shots that can protect both them and their babies, federal officials said today.

New research from the Centers for Disease Control and Prevention (CDC) shows that some women did not realize they needed to get tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) more than once.

A report published Tuesday in the CDC's Morbidity and Mortality Weekly Report (MMWR) found that the most common reason among a survey of over 2000 eligible pregnant women — 37.9% — for missing a Tdap shot was a lack of knowledge about the recommendation for this shot during each pregnancy.

With flu shots, the most common reason for missing them —17.6% — among survey respondents was a belief that they are ineffective, the CDC said.

In other cases, women reported concerns about getting vaccines during pregnancy, said Anne Schuchat, MD, the CDC's principal deputy director. On a call with reporters, she urged clinicians to take time to ask pregnant women about the two vaccines and seek to build their patients' trust in them.

Clinicians can refer to the body of evidence for the safety and effectiveness that underlay the CDC's endorsement for their use during pregnancy, Schuchat said. The American College of Obstetricians and Gynecologists also has many resources to aid with these conversations, she added.

The CDC recommends that pregnant women get a flu vaccine during any trimester of each pregnancy. They also should get a Tdap during the early part of the third trimester of each pregnancy as part of routine prenatal care.

"It's really important for clinicians to begin by listening to women and asking 'Can I answer your questions? What are the concerns that you have had?’ ” Schuchat said.

Clinicians might also consider telling women of their own history of getting vaccinated during pregnancy or that of their partners, she said. Schuchat's remarks were part of an effort by the CDC to boost vaccination rates among pregnant women.

For Mothers and Babies

The agency on Tuesday highlighted MMWR's publication of new research from an Internet-and-email survey on vaccine rates in pregnant women.

The CDC developed its estimates for influenza coverage based on responses from almost 2100 women. A smaller number — 817 — of eligible survey respondents knew their Tdap status. Only 34.8% of this group reported having received both the influenza and Tdap vaccines.

But rates were better for each vaccine on its own. About 54% of eligible respondents reported having had influenza vaccines before or during pregnancy. About 55% received theTdap vaccines, the CDC said.

CDC officials also sought to highlight the risk to women and children from influenza and pertussis. Whooping cough can be deadly for babies, especially before they can start getting the childhood whooping cough vaccine at 2 months of age.

And, babies under 6 months of age — who are too young to get a flu shot — have the highest incidence of influenza-associated hospitalizations and highest risk for influenza-related death among children, the CDC said. But influenza vaccination in pregnant women reduces the risk for hospitalization due to influenza in their infants aged younger than 6 months by an average of 72%.

"No baby should suffer or die from influenza or whooping cough because of a missed opportunity for the child's mother to be vaccinated while she was pregnant," Schuchat said. "And women have enough issues to address when they are pregnant without going through a difficult hospitalization."

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