Pregnant? Flu Shot May Come With Some Hassle

LAURAN NEERGAARD Associated Press

Sept. 28, 2009, 10:13PM

WASHINGTON — It's hard for pregnant women to escape the message: You're at extra risk from swine flu — it could trigger premature labor, hospitalize you for weeks, even kill you — so be among the first in line for the vaccine next month. But only about one in seven pregnant women gets a flu shot each winter.

While health officials are working hard to raise that number, repeated swine flu warnings won't overcome a key obstacle: Many obstetricians don't vaccinate. And not only are women reluctant to hunt for flu shots elsewhere, historically some pharmacists and others have been wary of vaccinating them.

“Maybe this year we can change that culture,” says Dr. Anne Schuchat of the Centers for Disease Control and Prevention. “It's not supposed to happen that you, when you are pregnant, are fighting for your life on a respirator.”

Pregnant women make up 6 percent of H1N1-confirmed deaths even though they account for only 1 percent of the population, according to the CDC. They're at least four times as likely to be hospitalized as other flu sufferers.

Vaccine is a two-for-one deal during pregnancy: It can protect not just mom but the baby, too, for the first few months after birth. That's important because flu can easily kill newborns, yet babies can't be vaccinated until they're 6 months old. 

The American College of Obstetricians and Gynecologists has no count of how many OBs offer flu vaccine, though it's still considered a minority. An extra complication: Each state's health department will decide who offers the H1N1 vaccine, aiming for locations that vaccinate the most people. Those decisions haven't been made public yet. Even if your OB requested shots, he or she may not get any, at least from initial shipments. So the CDC and ACOG are urging OBs to partner with a hospital or drugstore to guarantee their patients a shot, a message the government will reiterate Tuesday in a swine flu seminar for OBs nationwide.

Yet providers who don't routinely treat pregnant women may not understand flu's risk and the shot's safety record, says Dr. Neil Silverman of the University of California, Los Angeles. Take pharmacists, expected to be key vaccinators. Silverman gets phone calls from women who say a pharmacist won't fill a flu-shot prescription. For every patient who calls, “I know there are at least two who just say, ‘Well, OK, I'm not going to do this,' and just walk away.”

The American Pharmacists Association is urging its members to follow the CDC's pregnancy guidelines, but a few stores may still balk, says association chief of staff Mitchel Rothholz.