"Doctor, can I get the flu vaccine while pregnant?"

In autumn and winter, the temperature gradually drops.

Having just celebrated an exciting and joyous National Day holiday, temperatures have also dropped to a new low.

At this time of year, the infectious disease departments and fever clinics of major hospitals begin to get busy, as the influenza virus, which has been dormant for several months, is about to become active again.

Among the patients seeking medical treatment, there is a special group: pregnant women.

Why do expectant mothers often resist vaccines?

In fact, influenza can be effectively prevented through scientific and reasonable vaccination, so why do many expectant mothers still refuse to get vaccinated?

Your main concerns are probably these:

Vaccines are viruses; we should be avoiding them, why would we get them injected?

Will getting vaccinated during pregnancy affect my ability to breastfeed later?

I'm not even going to wear makeup anymore. What if some of the substances in this vaccine might affect my baby?

Besides, even if I don't get vaccinated, I might not get infected!

Let's address these questions one by one.

What types of flu vaccines are available?

First, the main types of vaccines include: inactivated vaccines, live attenuated vaccines, and attenuated vaccines.

Inactivated vaccines remove the pathogenicity and reproductive capacity of pathogenic microorganisms and their metabolites, but retain the ability to stimulate the human body to produce an immune response.

Live attenuated vaccines are produced by eliminating the pathogenicity of bacteria and viruses during the manufacturing process, but retaining their ability to reproduce and stimulate the human body to produce an immune response.

Flu vaccines are a type of inactivated vaccine.

During flu season, women who are pregnant or planning to become pregnant can receive the inactivated influenza vaccine if there are no contraindications. After termination of pregnancy, a live attenuated influenza vaccine can be administered.

Basically, it is perfectly safe for pregnant women to receive the flu vaccine at any stage of pregnancy.

Meanwhile, vaccination is highly effective in preventing pregnant women from contracting influenza and in protecting infants under 6 months of age through congenital antibodies (the process by which prenatal predispositions and diseases are passed from parents to offspring through the mother)—vaccinating pregnant women against influenza can reduce the risk of their infants under 6 months of age being hospitalized with influenza by an average of 72%.

The government is telling you to get vaccinated.

As early as 2012, the World Health Organization (WHO) stated in its "Position Paper on Influenza Vaccines" that pregnant women should be listed as one of the first priority groups for vaccination.

However, due to the lack of safety assessment data on influenza vaccination for pregnant women in China at that time, some marketed influenza vaccines still listed pregnant women as a contraindicated group for vaccination.

Finally, in 2018, the Chinese Center for Disease Control and Prevention released the "Technical Guidelines for Influenza Vaccination in China (2018-2019)," which defined pregnant women or women who plan to conceive during the flu season as priority recipients for vaccination.

Therefore, pregnant women or expectant mothers can rest assured to consult with doctors about flu vaccination!

Antibodies are also present in breast milk.

If a mother receives a vaccine before birth, her body will produce a large number of antibodies due to immune induction. During breastfeeding, the anti-influenza specific immunoglobulin A (IgA) can also be passed to the baby through breast milk.

Infants under 6 months of age are not suitable for receiving the flu vaccine, and breast milk is the only way for babies to acquire immunity.

If a pregnant woman contracts the flu while breastfeeding, she will not actually transmit the virus to her baby through breastfeeding.

However, it should be noted that the possibility of infection for babies is still very high, as it can be transmitted through close contact during breastfeeding, coughing, and droplets.

Once antiviral drugs are taken, whether it's oseltamivir or zanamivir, the drugs will appear in breast milk, and the breast milk cannot be used for feeding.

The U.S. Board of Immunization recommends that breastfeeding mothers avoid using antiviral medications for influenza.

Therefore, it is still very necessary to get vaccinated against the flu in advance.

But people with allergies cannot take it.

Patients with a history of severe allergic reactions to influenza vaccines should not be vaccinated.

In addition, the latest guidelines do not list egg allergy as a contraindication, but if you have a severe and obvious egg allergy reaction, you should still consult a regular hospital and a professional doctor.

How to choose a vaccine?

There are many types of vaccines, but which ones are safe to receive and which ones are not? Are you confused about which ones to choose?

Today we'll talk about several vaccines that are closely related to pregnant women and new mothers.

The "flu vaccine" candidate has passed the test—it is now safe to receive it.

The tetanus vaccine is an inactivated vaccine—it is safe to receive.

The U.S. Centers for Disease Control and Prevention recommends that pregnant women receive a flu vaccine during any three-month period of pregnancy.

As part of routine prenatal care, they should also undergo a DPT (diphtheria, pertussis, tetanus) test early in the late stages of each pregnancy.

So expectant mothers really, really, really need to pay attention!!

Can DPT (diphtheria, pertussis, tetanus) also transmit antibodies to the fetus?

Besides influenza, there is another virus that poses a great threat to newborns, but data also shows that it can be effectively prevented by vaccination. That virus is pertussis.

Whooping cough can be fatal in infants.

Data shows that in the United States between 2010 and 2017, the mortality rate from pertussis infection in infants under 2 months old was 69%.

The U.S. Centers for Disease Control and Prevention (CDC) states that approximately 20 infants die from whooping cough each year in the United States, and about half of children under one year old infected with the virus end up in the hospital.

Currently, research has confirmed that the DPT vaccine (for pertussis, diphtheria, and tetanus) can be administered throughout pregnancy, with the optimal timing being between 27 and 36 weeks of gestation. Furthermore, vaccination during pregnancy can provide the infant with partial immunity.

It is worth noting that the U.S. Centers for Disease Control and Prevention (CDC) recommends that pregnant women receive both influenza and pertussis vaccines at the same time.

However, in China, the main method for preventing neonatal pertussis is still to administer the DPT vaccine to newborns after birth.

However, judging from the vaccination data in various places, there is still a long way to go in recommending that expectant mothers receive the flu and DPT vaccines, both domestically and internationally.

Most people still have doubts about vaccines and are hesitant to get vaccinated. We want to remind the public that you absolutely, positively, must get vaccinated at a reputable hospital.

Finally, I would like to say that we still have a long way to go in terms of vaccine approval, production, promotion, and popularization.