Influenza vaccination in pregnancy - proven efficacy

By , 11 September 2014

Influenza vaccination in pregnancy - proven efficacy

Every now and then, a "landmark paper" - a paper of great clinical significance - comes along.  I believe we've seen one this week!

A paper published this week in the New England Journal of Medicine is the first to show, through the power of a randomised control trial (or RCT, the most rigorous way of determining whether a cause-effect relationship exists between a treatment and an outcome), that influenza vaccination during pregnancy protects mothers and babies.

The researchers enrolled over 2300 pregnant women and randomised them to receive the current influenza vaccination or placebo (saline), between 20 and 36 weeks of pregnancy.  From the date of vaccination, women were contacted weekly to detect symptoms of a "flu-like illness" and, if reported, they were tested specifically for influenza through highly-specific PCR testing.  Women were followed up until about 6 months after birth, and their babies were followed up from birth to about 6 months of age.  

As well as showing that both mothers and babies had "boosted" immunity (through testing the levels of protective antibodies in their blood), the researchers found an almost 50% reduction in PCR-proven influenza infection in both mums and babies.

This is of major public health importance for two reasons: firstly, pregnant women are recognised as being the adult group at highest-risk of severe influenza illness during epidemics and pandemics, even in high-income countries like Australia.  Secondly, young infants are particularly susceptible to (and may be severely affected by) influenza illness, and no vaccine is currently licensed to protect this age group.

Influenza vaccination is already recommended (and PBS subsidised) for pregnant women in Australia.  It does not contain live virus, and the composition of the vaccine changes every year, to keep up with the current seasonal influenza virus strains.  This study provides final validation that influenza vaccination in pregnancy is a good idea, and the researchers are to be congratulated.

Now, go and get your vaccination!

 

Influenza vaccination in pregnancy - proven efficacy
 

About Dr David Moore

Influenza vaccination in pregnancy - proven efficacy

David is a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, and undertook his specialist training in Queensland.  He is highly skilled in the management of complex and high-risk pregnancies, and has special training in minimally-invasive surgery, endometriosis, pelvic floor and incontinence surgery.  David has completed a Master of Reproductive Medicine and is skilled in the assessment and management of fertility problems, and can offer the full range of assisted reproductive treatments.  He is a Senior Lecturer with The University of Queensland Medical School, and has published both medical journal and textbook contributions.

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