Ahead of the start to flu season, the US Centers for Disease Control and Prevention (CDC) today said not enough pregnant women are getting vaccinated against flu and pertussis (whooping cough), two diseases known to put mothers and their babies at high risk for complications.
The CDC detailed the gap in protection and what's at stake today in a Vital Signs report that appears in an early edition of Morbidity and Mortality Weekly Report (MMWR). The CDC recommends that all pregnant women be vaccinated against flu during any trimester of each pregnancy and that women receive the tetanus, diphtheria, and pertussis (Tdap) vaccine at the start of the third trimester of each pregnancy.
At a media telebriefing today, Anne Schuchat, MD, the CDC's principal deputy director, said the report contains new data on uptake for both vaccines—based on a survey of nearly 2,100 pregnant women ages 18 to 49—during the 2018-19 flu season. According to the findings, 54% of pregnant women reported they were vaccinated against flu before or during pregnancy, and 55% reported receiving the Tdap vaccine during pregnancy.
Only 35% of women received both vaccines, she said.
Among the survey's other key findings were that women who received vaccination referrals from their health providers had the highest vaccination rates, and black non-Hispanic women had lower vaccination levels than other racial groups and were less likely to get a referral from their health providers.
Both vaccines have good safety records in pregnant women, but there's room for improvement in the communications that doctors have with their patients who are pregnant or planning to become pregnant. For example, 38% of women in the survey did not know that the Tdap vaccine is recommended for each pregnancy.
Disease risks to babies and moms
Health officials worry about the impact of both diseases on mothers and babies, but they are especially concerned about the risks for newborns who are too young to be vaccinated against either disease. The vaccines are recommended during pregnancy because women pass antibodies to the developing babies that protect them against the infections after birth.
According to the Vital Signs report, since 2010, among women ages 15 to 44 who were hospitalized for flu, 24% to 34% were pregnant, though only 9% of women in that age-group are pregnant at any given time.
Schuchat noted that, among children, babies younger than 6 months old have the highest risk of hospitalization and death from flu. And she said babies with pertussis can become very ill, gasping for air. No baby should suffer from a missed opportunity to vaccinate mothers, she added.
Strategies for health providers
According to the survey, three fourths of health providers offered the vaccines to pregnant women, but about one third did not get immunized.
Schuchat had some suggested strategies for encouraging pregnant women to be vaccinated against the two illnesses. It's important to begin by listening to women's concerns about vaccination to help build trust and respect, she said. "Then provide the basis of the recommendation."
Regarding the flu vaccine, it's useful to begin the conversation early in pregnancy and give women resources to read. "So that when flu season comes, they're prepared to make a choice," she said. "Having time to learn can be helpful." The CDC and the American Academy of Pediatrics both have scripts and other resources that can help doctors discuss risks and benefits with pregnant women.
Also, she said having vaccination available right in the office has been linked to higher uptake levels.
Oct 8 CDC MMWR early release Vital Signs report
Oct 8 CDC press release
Oct 8 CDC Vital Signs landing page