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Maternal influenza vaccination during pregnancy may protect infants
Eick AA. Arch Pediatr Adolesc Med. 2010. doi:10.1001/archpediatrics.2010.192.
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Infants of mothers who had received an influenza vaccination during their pregnancy were nearly 40% less likely to be hospitalized for influenza-like illness, according to study results.
Researchers from the Center for American Indian Health and others followed patients from six Navajo and one White Mountain Apache Indian reservation hospitals during one of three influenza seasons.
Among 160 mother-infant pairs, results indicated that among infants, 17% had an influenza-like illness (ILI) hospitalization, 36% had an ILI outpatient visit and 48% had no ILI episodes.
There were 7.2 incidences of ILI per 1,000 person-days for infants born to unvaccinated women, compared with 6.7 per 1,000 among infants born to vaccinated women. Vaccination was associated with a 41% reduction in risk for laboratory-confirmed influenza (RR=0.59; 95% CI, 0.37-0.93) and a 39% reduction in risk for hospitalization due to ILI (RR=0.61; 95% CI, 0.45-0.84) compared with non-vaccination.
The researchers noted significantly higher hemagglutinin inhibition antibody titers at birth and at 2 to 3 months in infants born to vaccinated women compared with those born to unvaccinated women.
This is the second recent article to demonstrate the protective benefits in early infancy when the mother receives influenza vaccination during pregnancy. As noted by researchers at Johns Hopkins and the CDC, a nearly 40% reduction in both flu-related infection and hospitalizations for native American infants is quite profound. The earlier study by Zaman et al showed a 63% reduction in influenza illness in Bangladesh infants.
Why is this passive flu vaccination of infants via the mothers so critical to all pediatricians? First, we have no way currently of directly vaccinating infants for the first 6 months of life; second, this infant group has the highest hospitalization rate from flu of any healthy age group; third, we have no FDA-approved means of treating this infant age group, even when we determine they have the flu. Lastly, I hate doing septic workups and hospitalizations of febrile newborns — which could have been prevented — and which involves an inordinate amount of my office time, skills and worries.
Thus, I beg every pregnant mother and postpartum mother and father that I see in my office, there for whatever reasons, to get their flu vaccine during the vaccine season. Most of our obstetrical colleagues, who tend to do a poor job of vaccinating, do not understand the health benefits and the costs saved to our infants and to my practice when the pregnant mother is immunized, especially since almost half of our pediatric practice population is capitated and indigent.
We desperately need a newborn flu vaccination program developed.
– Stan L. Block, MD
Infectious Diseases in
Children Editorial Board member