Swine Flu vaccination whilst pregnant?

[Bobbaz]

I've just receieved a letter from my GP asking me to go for the vaccination as I'm in the high risk group being 6 months pregnant. If I won't take the vaccination I have to sign a letter declaring that I'm refusing it. Dilema, what do I do for the best? Obvioulsy the GP says the benefits outweight the risks but I can't help but be cautious and think about the whole Thalidamide situation. Am I just being paranoid? Should I just get on and do it?

[R&A]

There are some articles in The Times and some bbc podcasts which help explain the pros and cons really well.

At 6 months the baby is developed anyway - unlike those poor woman who took thalidomide ...

Saying that it's fever that is thought to cause birth defects so it's a risk not to take the vaccine

I'd recommend reading around the subject a little and making your own decision

Personally i'm getting it on Saturday morning (i'm nearly 9 months pregnant) but i have spent a LOT time researching to come to this decision. What swayed me was the possibility of transfering antibodies (either through me or breast feeding) to my baby. I don't think you can vaccinate very young babies and I'd feel terrible if there had been something i could have done to prevent the baby suffering.

That was what swung it for me but listen to the podcasts and read the articles and you may come up with a different conclusion

[Bobbaz]

Thanks, that actually reassuring to know you've read around it and decided to go for it. I have read around it on the internet but as everything gives a pretty balanced view point for every pro there's a con and vice versa it seems. Have to say I do agree with the point you raise about passing on the antibodies to your baby. Hope all goes well with your birth! Thanks

[darlin']

Hi

I'm in the same position, trying to decide and agree that it is very difficult!

There's a very good Q&A page about it on Mumsnet where a doctor answers people's questions and that has swayed me more towards having it. http://www.mumsnet.com/onlinechats/david-salisbury

Apparently in some countries such as Canada they are offering pregnant women a special vaccine without the mercury and I wish they were offering the same here, then it wouldn't even take a moment to decide. Does make you slightly wary to know other countries recognise it isn't safe and are offering an alternative.

Then again, a friend of mine who works at Tommys says that pregnant women are amongst those being admitted to ICU and are suffering the very worst (along with young children).

There is also a very thorough and helpful discussion on SE23.com about it.

http://www.se23.com/forum/showthread.php?tid=2466

[Cora]

I had it last week (six months pregnant|0 and admit felt very nervous about it. This week one of my children had 'flu like symptoms' and I was really relieved I could hug and comfort him without the fear that I might contract swine flu from him. I remember hearing on of the top medical bods saying that if you contracted swine flu it would not pass to the baby but the danger is in you getting a fever which could affect the baby. My logic eventually was that if the illness itself would not transfer to the baby then the vaccine wouldn't either.

A warning though, it is the first vaccination to affect my health - it laid me low for a couple of days including a dead arm for three days. Make sure you get it done when you know you can lay low for a bit.

[ClareC]

I have really looked into this and read loads on the subject. I am high risk on two counts, being pregnant and asthmatic!

The one area I really struggle to justify is that the injection has not actually been tested on pregnant women! If there are side effects, unfortunately these will only be discovered at a later date. Of the 5000 people tested some became pregnant afterwards, however, there is a big difference between getting pregnant afterwards and being pregnant at the time!! 5000 seems a pretty small test group to me too :-(

I have a good friend who is a GP, I spoke with her about the whole thing and asked her if she were me would she have the jab, her answer was a definite no! She won't have it herself either.

There really isn't a right or wrong answer, there seems to be risks associated with both having it and not having it :-(

When my baby is born I will definitely be asking all visitors to wash their hands on arrival! Paranoid maybe but apparantly very effective for an illness that actually isn't that contagious!

[nylonmeals]

Realise that this thread is an old one, but important for mums-to-be to know the vaccine options that are out there as there seems to be a lot of misinformation out there. Pandemerix is the most commonly used vaccine in this country - it does however contain mercury and adjuvant (neither of which are great for pregnant women) In Europe and Canada they are not recommending this type of vaccine for pregnant women. Their recommendation is for the adjuvant-free, mercury-free version which in the UK is called Celvapan. It is more expensive (as it requires 2 shots) and less has been ordered in the UK. But according to medical friends this is their recommendation. However you either have to have an egg-allergy (or tell them that you do...)

[Sanne Panne]

> However you

> either have to have an egg-allergy (or tell them

> that you do...)

I believe that back in November the NHS sent a letter to all GP practices saying that if a pregnant woman will only accept the vaccine if she can have Celvapan that they have to offer her Celvapan because according to the NHS it's better to spend the money than to not vaccinate pregnant women at all. In that case there would be no need to lie about an egg allergy.

Let me see if I can find an official link somewhere... I believe the letter itself is even available online. Hope my source wasn't wrong... will get back on this

Found the link: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_108855.pdf

[sbain]

Hi,

My first baby is due in April 2010 and I was terrified of getting the Swine Flu Vacine and also terrified of getting Swine Flu. I went so far as to make the appointment and cancel it. Eventually I spoke to a doctor friend of mine who happened to also be pregnant - she got it in very early pregnancy after talking to an expert in the field and really put my mind at rest. The expert she spoke to (a consultant of a type I don't recall but specialising in vacinations) siad that she really couldn't understand all the brou-ha-ha in the press. The vacine is the same as every other flu vacine with a new inactivated piece of flu DNA in it. They have been giving flu vacines to pregnant women in the US for years with no issues. Apparently the amount of mercury in the vacine is less than the amount in a can of tuna. I haven't checked this info - but really trust my doctor friend so I went ahead and got the vacine. So far as I can tell there has been no effect on bump and I luckily didn't have the dead arm problem - a bit sore for a day or so but that was all.

[Ann]

Thanks for adding that sbain, hopefully that will reassure other pregnant women that the vaccine is safe as indeed flu vaccines have been in the past.

I'm curious as to why so many women are afraid of the Swine Flu vaccine bearing in mind that flu although unpleasant has never been shown (I think) a detrimental effect on a fetus?

I wonder if the on-going controversy about the MMR has a part to play in this inasmuch that vaccination programmes have previously been very successful, certainly in terms of uptake?

Smallpox, for example has now been completely eradicated worldwide and wouldn't have without an effective vaccine. As Flu is a virus this can't be so as ( I believe ) a virus is harder to iradicate due to it's simplistic form; hence no cure for the common cold.

I'm interested to hear what some of you think.

[Sanne Panne]

Smallpox is a virus too - the difference with flu is that new influenza strains show up each year so it's impossible to prevent (or cure) flu as a whole.

Regarding the vaccination: I agree that just "fear of the new" needn't be a reason not to get vaccinated - it should be a reason to do more research. And indeed, modern vaccinations are pretty much always safe but since there have been medical blunders in the past (with pregnancy related blunders being a highly sensitive topic), it is sometimes hard to believe that "now in 2009/2010, medical scientists really do always know what they're doing". They're doing their very best but we're not at the very maximum of knowledge yet so we can't be sure about everything. We do have to trust national advice generally, but sometimes it's scary, especially when you're in a more vulnerable position because you're pregnant.

Of course the swine flu vaccine is nearly identical to other flu vaccines (which are indeed pretty much proven safe) and just adding a different strain to the flu shot is nothing that isn't already done every year anyway - but the fears are about thiomersal (inherited from the MMR controversy which has already been contradicted many times but once there's a controversy it's hard to let go...). I'm personally not worried about thiomersal but I am still a bit uncomfortable with squalene, the adjuvant that's not been studied much yet and that is probably safe but there isn't much safety data available yet (that I know of). The adjuvant is banned in Canada and not used on pregnant women in the US, probably more because of inconclusive data than because of genuine safety concerns... but still! And I think it's that "but still" feeling that makes so many people (including me) postpone their decision.

Edited to add that squalene is not used in the regular seasonal flu vaccine.

[ClareC]

In addition, although the seasonal flu vaccination was used for pregnant women in America, it wasn't in this country until this year when the swine flu vaccination was being pushed. If you read the information provided by the NHS the question "is it safe to have the vaccination when pregnant" does not confirm it is....... they simply don't know, its not been tested on pregnant women. It is something that will continue to be unknown for sometime. Research suggests it is but there is nothing conclusive confirming this.

I opted not to have the jab despite being pregnant and having asthma - from what I read the risk of me having the jab was with my baby whereas the risk of me not having it is with me. I understand that in early pregnancy it is slightly different as the high temperature the flu causes can be harmful to the baby.

I sincerely hope there are no detrimental effects from having the jab, it really is one of those area's where you just need to research as much as you can and make an informed choiced based upon your personal circumstances.

I took advice from my friend who is a Dr too...... she wouldn't have it in my position and hasn't had it herself, neither have any of the other GP's in her practice.

That doesnt make them right, just highlights that even the experts dont agree! There is no right or wrong answer, you just need to do what is best for you and what you are most comfortable with.

[jollybaby]

Clare C am afraid you'll find that most drugs won't have been tested on pregnant women as running a drugs trial in pregnancy is near impossible (would you agree to take part in such a trial) . Data on the use of drugs in pregnancy is almost always gained retrospectively ie from women who have taken a drug out of necessity or inadvertently before realising they were pregnant. This means that realistically the safety data on this vaccine won't be available for several years which doesn't really help women trying to make this difficult decision now.

[ClareC]

I do realise that, I don't believe it's allowed (in this country) even if there were willing volunteers (which I would be surprised if there were) They test on pregnant animals (rats) instead. The results of these tests can be found online.

When I was first pregnant I suffered with hayfever quite badly as I couldnt take my usual antihistamines. My GP friend is also quaified in homeopathy and uses both standard drugs and homeopathy to treat her patients as appropriate (I wish sge practiced round here).

She mixed me up a homeopathic cure for the hayfever, and told me if I really had to resort to antihistamines to take piriton given its longevity on the market rather than my usual zirtec which is a relativly "newer" drug. She confirmed that the longer a drug is on the market the more they know of its side effects etc. As you say, it is those pregnant women who have to take the drugs for one reason or another that effectively test them for future use. Hence all boxes of medicines seemingly saying not to use when pregnant unless directed by a physician.

Pregnant women having the swine flu jab now are effectively the current testers, although given the seasonal flu jab's use on pregnant women in the States for some time it is not an entirely "blind" test!

There are simply certain situations when the Gov feels the benefit outweighs the risk, the question is whether the individual agrees and therefore is willing to take the risk (albeit hopefully small). Coming from a legal background I am probably more cynical than most on this aspect of the debate!

[Sanne Panne]

What I don't get is how governments or medical bodies can't gather and publish more data on medicines that pregnant women decide to use during their pregnancy and combine these with the outcome of their pregnancies. I guess that type of data doens't meet the guidelines of what you can call a proper test.

I have used the same anti-allergic nasal spray for 20 years and it's another one of those "only if the benefits outweigh the risks" medicines. I believe it had recently been upgraded from C to B in the US FDA coding system (meaning animal tests have been favourable but no human tests have been done). My GP couldn't tell me more than "only if the benefits outweigh the risks"... uuummm what are the risks? No idea. So how can I tell whether the benefits outweigh the risks? So I searched and searched and ended up paying for a medical article I found online and got my answer: a Swedish study that recorded medicine usage and pregnancy outcome and if the number of users was big enough it would mention whether there was a statistically relevant correlation. I kept using my spray without having to stress.

To make a long story short: would be nice to have more of this type of data. Not as an official recommendation but as a guideline to help pregnant women make their own decisions!

[ClareC]

I entirely agree!

It is so hard trying to find this type of data yet it should be recorded as standard by an independent body. Guess it all comes down to cost.

Drug companies do pool their information on testing / use / adverse effects etc on all drugs, not just in relation to pregnancy but all manner of side effects etc. This is published but not publicly and only within the syndicate drug company members.

Unfortunately it comes down to money - Potential liability and profit - it is not in the drugs companies interests to make this information publicly available. They are extremely sensitive about who gets to see it and its uses. Course even if it was publicly available it woulrnt help with swine flu, that info wont be around for a while yet.

[sandy_rose]

I'm having a homeopathic immunisation to normal flu and swine flu. There are no guarantees, but I've always found homepoathic remedies useful in the past and at least there are no risks.

[Vangough]

Blimey this is all terrifying, I had the swine flu jab at @ 18 weeks pregnant (under huge pressure from my GP as I commute to central london every day) but now I wonder if I should have done !!!! when everyone talks of 'risks' - what exactly are these?

[ClareC]

try not to worry! I know people that had the jab and the babies have now been born and are fine!

The risk is that the risk is unknown at this stage which is the same for any new drug. It really is a case of working out what is for the best in each persons personal circumstances.

Commuting into London each day during winter months will make you higher risk of catching SF so having the jab was the right decision for you! A good friend of mine has just had it at 22 weeks for the same reason - she wasn't going to until a close work colleague caught it.

As no drugs are tested on pregnant women the medical profession avoid giving any unless the benefits outweigh the risks. An example of this is drugs for asthma, lack of oxygen is far more risky to the baby than asthma drugs hence although these were not tested on pregnant women it was deemed appropriate those that needed them should take them and subsequently they are now known to be "safe", ie through years of pregnant women taking them and there being no known detrimental effects..

Please do not worry, I chose not too have the jab but that doesn't make that the right choice, it was right for me in my circumstances - I was commuting into London in autumn not winter which is peak season for these kind of illnesses.

You can only do what you think is best in the circumstances which is what you did upon the advice of your Dr. There really isn't a wrong or right in this!!

Don't worry!

[Ann]

ClareC you have made some relevant points, but I would point out that the Swine Flu jab is a vaccine and not really a drug. As you probably know a vaccine is a small dose given to make our immune system build up an antibody which would then protect from the actual disease.

In that sense I can't see why there would be any other risk to the unborn baby than the usual viruses pregnant women can succumb to. In a crowded city like London we certainly share our viruses! I have never met anyone who has lost a baby due to flu.

I certainly had a nasty 'flu like' illness shortly before my son was born and he's been blessed with good health all his life so far.

I suppose the point I'm trying to make is that a vaccine can't really be more harmful than an actual disease and flu has never been linked to particular problems in pregnancy, as far as I'm aware.

[ClareC]

As I understand it the risk to the baby of a mother catching swine flu (or any other illness that causes maternal high temperature)is an increased risk of miscarriage / early labour. I don't know statistically how much of an increase this is, from what I read it didnt come across as being significant. As far as I am aware there is no other risk to the baby should the mother catch the virus during pregnancy. I am not a Dr though so am only reiterating information I learnt when I researched this.

The risk is more to the mother herself, pregnancy being an "underlying condition" - I believe this is twofold, low immmunity due to being pregnant ie more likely to catch the disease, and the repiratory problems upon catching it given that breathing is harder during pregnacy due to squashed lungs.

As to the difference between a vaccine and a drug - I appreciate they are not the same, The point I was making is that drugs, ("drugs" beimg a generic term for something manmade presumably by a pharmaceutical company to treat or prevent illness ie the term "drugs" wasn't intended to exclude vaccines) are not tested on pregnant women hence the situation described above.

As for the risks associated by having the vaccine, there are mixed views hence this whole debate! An individual can only research those views published by the specialists and make their own mind up! The NHS information sheet for pregnant women does not state there to be no risk, although the heading is there in the question and answer format the answer rather avoids the question entirely.

Hope that clarifies my post