Pregnant women face an unusual and stressful challenge this year. How do they really know, with all of the outright false and misleading information distributed by public health agencies, that this year’s flu shot is safe?
An online poll reveals 414 of 552 women (75%) would not undergo flu vaccination against the H1N1 pandemic flu. Yet pregnant women are considered to be in a high-risk group for flu-related mortality.
Pregnant women are chatting on internet message boards, and the following reports, if true, are a bit horrifying. Here are some from an About.com site, monitored by Krissi Danielsson. (Numbers refer to the online posting.)
Read this recent posting:
November 3, 2009 at 4:30 pm
(8) Connie says:
I also received the H1N1 vaccination on October 22nd, 2009 and went into labor on October 25th, at 16 weeks pregnant and we just heard the heartbeat and everything was fine with my pregnancy on October 16th, 2009, then on October 28th my water broke then on October 29th, I delivered a stillborn baby boy, and no one can tell me why…Everyone wants to say it did not come from the shot but I believe it did. My baby was growing at the correct pace and everyone wants to brush off the vaccination. I say if you have the vaccination and suffer a miscarriage if they are able to perform an autopsy have it done.
There are more stories like these:
October 26, 2009 at 11:07 am
(2) Regrets says:|
I got both vaccines on Thursday. I was 9 weeks pregnant. I miscarried on Sunday. I was told by several doctors to get these vaccines. Now I wish I followed my gut feeling and not get them at ALL!
October 29, 2009 at 8:33 am
(3) :( says:
I work in a hospital like setting and was told ‘the benefits outweigh the risks" 1am I got the vaccine, 3am I started bleeding and cramming, 3pm miscarried. You decide
October 31, 2009 at 1:29 pm|
(4) sue says:
I had the H1N1 vaccination and 24 hours later had a miscarriage
Frankly, these could all be coincidence, but then again, read this posting:
November 6, 2009 at 11:00 am
(40) kathy-sd says:
I’m from a town of 2000 in SD, there are several women pregnant and we are all due within a few weeks of each other. Four of us got the H1N1 vaccine 2 weeks ago and one by one each of us started to have preterm contractions. We are all due in Nov and Dec so we are further along than most of the people that lost their babies. There is no way you can tell us that our preterm labor was not caused by the H1N1 vaccine. It may look like a "fluke" to some people when these women are scattered all over the country but we are talking about 4 of us in our small community. My heart goes out to all of you that lost your babies.
There are more pregnancy/flu-shot horror stories involving stillbirths you can find here.
Yet pregnant women have been told that the vaccine is safe and they are told they are in a high-risk group for flu-related mortality. (Flu-related death does not appear to be due to the flu but rather the treatment for the flu. See here.)
The H1N1 pandemic vaccine has only recently undergone testing in pregnant females. A report says "To date, the vaccine appears to be well-tolerated, and no safety concerns related to the vaccine have arisen."
Poland rejects the vaccine
But a health minister in Poland speaks out on YouTube, stating that there are numerous websites for manufacturers of this year's H1N1 pandemic flu vaccine, yet she cannot find reports of any unwanted side effects for these vaccines. Poland has elected to avoid use of the vaccine among pregnant women.
Polish health minister Zdrowia challenges her medical colleagues: "I would like you to visit any of these (vaccine manufacturer) websites and find any unwanted side effect. Any slightest thing, at least one, like allergical skin rash. That can happen even with using the safest medicine. There are none on those websites. It is a ‘perfect medicine’."
She then goes on to ask, why, if this vaccine is perfectly safe, do manufacturers seek exemption from legal recourse by patients harmed by the vaccine?
Stillbirths and the flu
The horror for these women is that they dutifully followed their doctor’s advice to get inoculated for the H1N1 influenza and lost their pregnancy and now wonder if vaccination was the cause of their lost pregnancy.
About 26,000 stillbirths occur in the US every year (~70 per day), and an estimated 3.2 million worldwide. [Obstetrics Gynecology 2009 Oct; 114(4):901–14.] Just how many stillbirths or birth defects are caused by flu infection during pregnancy has been difficult to ascertain.
Studies involving stillbirths are recognized to be flawed. They almost entirely rely upon hospital births which are obviously skewed towards problem pregnancies.
The scuttlebutt circulating on the internet is that some 50 percent of pregnant women experience stillbirths or lose their pregnancy anyway (which is erroneous), so how can the loss of a pregnancy be blamed on a flu shot?
It is generally believed that infection of any kind, bacterial or viral, may increase the risk for stillbirth.
It is estimated, in developed countries, between 10% and 25% of stillbirths may be caused by an infection (virus, bacteria, protozoa). [Seminars Fetal Neonatal Medicine 2009 Aug; 14(4):182–9.] But again, this a broad guesstimate.
Chart shows the absolute number of stillbirths in Kanagawa (A) and Osaka (B), Japan, in the years prior to and during the Spanish flu pandemic. The continuous line represents the number of anticipated stillbirths in the absence of the flu, and the circles represent the observed number of stillbirths in a given month.
Only very recently has a reliable report been produced regarding stillbirths and influenza. During the Spanish flu, health authorities in Japan accurately recorded stillbirths during the pre-pandemic period of 1913–1917, and the pandemic period 1918–1920. About 7.5 to 9.0 percent of births in two cities (Osaka, Kanagawa) during the 1918 flu pandemic were stillborn.
Using this 1918 data as a model, given 30,000 stillbirths per year among 1.1 million pregnant women in Japan today, which represents 2.7% of births, the flu would increase this number by an additional 3000–9000 stillbirths, to about 3.5% of births. That would be an increase of less than one stillbirth per 100 live births. [Obstetrics & Gynecology and Reproductive Biology 147 (2009) 111–115]
If this 1918 model were applied to the US today, where there are ~4 million births annually, there would be about 32,000 excess stillbirths due to the flu. But that number is obviously flawed because it represents more than all the stillbirths reported annually in the US.
The problem is this model is based upon an unprecedented flu outbreak in 1918 which no other pandemic can be compared to in severity or loss of life. There were previously unrecognized factors, such as the only recently recognized worldwide over-use of aspirin to control fever during the 1918 Spanish flu which may have induced vitamin C deficiency and lung inflammation (pulmonary edema), with resultant mortality.
The question remains, do pregnant women face a significant increased risk for stillbirth due to the flu? If not, why vaccinate?
Vaccination during pregnancy
The customary practice for pregnant women has been to advise against any vaccination of any kind during pregnancy and to receive inoculation against measles, hepatitis B, mumps and tetanus prior to pregnancy or following birth. [International Journal Gynaecology Obstetrics. 1993 Jan; 40(1):69–79]
Yes, it is true, that a controlled study did recently show that flu shots reduce influenza-like illness by more than 30% among pregnant women and reduce the viral count in the blood circulation among 63% of pregnant women and infants. [Obstetrics Gynecology 2009 Aug; 114(2 Pt 1):365–8]
Yes, fine, the flu shot prevents flu-related illness, the characteristic fever, diarrhea and cough. Yet the question remains, does the flu shot reduce flu-related mortality and stillbirths, and is there any possibility that flu vaccination in any way might increase the risk for stillbirth?
Higher flu-related maternal mortality was reported in 1918 and 1957 flu outbreaks, but not in other years. Rates of hospitalization have been significantly elevated due to seasonal flu infection beginning in the 1st trimester of pregnancy, but vaccination to prevent serious outcomes is yet to be demonstrated.
Vaccination against influenza is recommended in the US for all women who will be pregnant during the influenza season to prevent the occurrence of influenza and the development of pneumonia. There is still no firm evidence that maternal influenza infection is associated with an increased risk of spontaneous abortion, stillbirth, birth defects, or mortality. [Nippon Rinsho 2006 Oct; 64(10):1930–3]
Why not let pregnant women endure the symptoms of their bout with the flu and avoid any untoward side effects caused by the vaccine?
Canadian researchers say "evidence is otherwise insufficient to recommend routine seasonal flu vaccination as the standard of practice for all healthy women beginning in early pregnancy." [Vaccine. 2009 Jul 30; 27(35):4754–70] That certainly is not what American women are hearing.
Health authorities in Switzerland do not permit use of the H1N1 pandemic flu vaccine among pregnant women this flu season (2009–10).
November 9, 2009 at 3:32 pm
(173) Beth says:
It baffles me that if a woman has a miscarriage during the flu, the flu is the immediate cause for miscarriage, and reason why pregnant women should rush to be vaccinated? However, if a woman has a miscarriage the day after a vaccine, they are told it is "not" the vaccine. I’m sorry. That makes no sense.
Imagine the anxiety pregnant women are undergoing this flu season. A pregnant woman, after reading online accounts of stillbirths following flu vaccination, writes:
November 9, 2009 at 11:57 am
(161) J says:
I’m 7 months pregnant and had the vaccination 2 weeks ago, I am absolutely terrified after reading this.
November 13, 2009