WP: Pregnant Women in DC area cautious about flu shot

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From two weeks ago -but still relevant

Pregnant Women in D.C. Area Cautious About Flu Shot

By Annie Gowen

Washington Post Staff Writer

Thursday, August 20, 2009

They are usually urged not to drink coffee, sip wine or pop aspirin. But now

pregnant women find themselves high atop the federal government's priority list

for those who ought to receive the new swine flu vaccine -- a prospect that some

mothers-to-be are greeting with caution.

Although the vaccine is in clinical trials and won't be available until fall,

expectant moms in the region are starting to ask their doctors, and each other,

whether the H1N1 vaccine is safe for them and their babies. Swine flu questions

now mingle with sale notices for strollers and nanny postings on local community

e-mail lists.

The Centers for Disease Control and Prevention and the American College of

Obstetricians and Gynecologists are recommending that all pregnant women be

vaccinated against swine flu after a study in the Lancet medical journal last

month showed that pregnant women are four times more likely to be hospitalized

from the disease than people in general. Fifteen swine flu patients in the

United States were expectant mothers -- about 6 percent of all swine flu deaths

reported to the CDC. Pregnant women make up 1 percent of the U.S. population.

The CDC and the obstetricians' group have long urged pregnant women to get the

seasonal flu vaccine and said it is safe for all trimesters. But a surprisingly

low number -- less than 15 percent -- do so, according to the CDC. That's in

part because some expectant mothers are loath to get vaccines or take

over-the-counter medicines, experts said.

Maggie Little, director of the Kennedy Institute of Ethics at town

University, who has written extensively about pregnancy and risk, said there is

often a strong reticence by pregnant women and providers to take medications --

even ones that are relatively low-risk.

The culture " tends toward perfectionism and control around pregnancy, " Little

said. " Pregnant women drive themselves crazy sometimes, doing more harm than

good, like not taking the medication they need. "

She is worried about the consequences of that mindset, warning that " if we get a

bad resurgence of the flu and these women don't get vaccinated, we're going to

have a lot of dead mommies and babies. "

Acadia Roessner, 31, a D.C. resident and government contractor pregnant with her

second child, said she was " still a little bit on the fence " about whether to

get the vaccine but is leaning toward getting it if it is deemed safe. Her due

date is in January, so she wonders whether she could avoid the vaccine and

remain flu-free for the last eight weeks of her pregnancy just by being careful,

washing her hands and taking Vitamin C.

" Certainly it's not something to take lightly. I'm weighing all the options, "

Roessner said.

But many moms -- as well as some special interest groups concerned about vaccine

safety -- worry about whether the new vaccine will have been tested enough

before millions of doses are administered this year.

The National Institute of Allergy and Infectious Diseases is testing the vaccine

on 2,800 children and adults and will be testing it on 360 to 720 pregnant women

beginning in mid-September, said S. Fauci, the institute's director.

" This influenza vaccine . . . is being made in the same way and by the same

companies we have worked with every year for seasonal flu vaccine, literally for

decades, " Fauci said. " Although you never take the safety issue lightly or

presume anything, historically the use of it [with pregnant women] has not been

a red flag-issue. "

A new Washington Post-ABC News poll shows that Americans are not as concerned

about a possible swine flu pandemic as public safety and health officials seem

to be -- more than six in 10 are not worried, although more than half said they

would probably get the vaccine, according to the poll.

" My chances of actually getting swine flu are slim to none, " said Keenia ,

23, a student at mount University who is pregnant. " Why take this vaccine?

What if it makes me sick in other ways? What if I find out after I take it it

could be harmful to my baby? I'm a little worried about that. "

Lubell, 36, a personal trainer who is pregnant with her second child, said

she will not get the vaccine, in part because she said she had a bad reaction to

a seasonal flu vaccine in college. She's careful about what she eats while

pregnant, she said, but will occasionally treat herself to a cup of coffee or

ice cream.

" I'm a not an expert. I am not a scientist. I am not a doctor, " Lubell said. " I

have to make my decision based on the information I hear and my intuition. "

Her intuition is saying no.

" I personally don't understand if you're perfectly healthy person why you'd

inject yourself with something that could potentially cause risk to you and your

fetus, " Lubell said.

A pregnant woman's body is more susceptible to flu for several reasons, experts

say. Pregnant women typically have altered immune systems and, in the advanced

stages, their growing bellies compress lung capacity, which can make them

vulnerable to pneumonia -- a potentially fatal complication of swine flu.

Local obstetricians and midwives say they have been fielding more questions

about the vaccine in recent days.

" I get a couple of phone calls and patients every day asking about it, " said

obstetrician Pickford, who delivers babies at Inova Fair Oaks Hospital.

" Most of them are wanting to know how to get it. I tell them it's not out yet. "

But she will probably recommend that they get it.

Laurel Todd, 30, a health policy analyst who lives in Glover Park, said she has

been monitoring media reports about the spread of the flu -- as well as fielding

concerned calls from her mother-in-law on the topic. She plans to get the

vaccine when it's available if her doctor says it's safe.

" I'm totally comfortable with it, " Todd said.