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The safety of influenza vaccination during pregnancy

van Leeuwen, Lotte (2019) The safety of influenza vaccination during pregnancy. Colloquium, Medical Pharmaceutical Sciences.

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The influenza virus is a respiratory pathogen that causes many cases of hospitalization and death each year. For this reason, vaccination is recommended for persons who are at increased risk from influenza complications, such as pregnant women. Although pregnant women do not have a higher incidence of seasonal influenza than the general population, they are more vulnerable to serious influenza-related complications because they are immunocompromised. Subsequently, influenza-related hospitalization of healthy pregnant women occurs an 18-fold above that of healthy nonpregnant women. However, rates of maternal influenza vaccination remain suboptimal. It is possible that isconceptions about influenza vaccine effectiveness and skepticism about influenza vaccine safety may be contributing to the poor uptake by pregnant women. Therefore, we analyzed data on the safety of influenza vaccines in pregnant women. No evidence was found on increased risks for maternal outcomes; pre-eclampsia or placental abruption after vaccination. We did find evidence on decreased risks for maternal fever after vaccination. When looking into fetal safety, we analyzed if the use of adjuvanted vaccines (AS03 and MF59) during pregnancy were associated with congenital anomalies. Effect estimates showed no statistically increased risks for fetal congenital anomalies for both the adjuvanted or the unadjuvanted vaccines. Other fetal outcomes such as fetal death or preterm birth were also not associated with an increased risk after maternal vaccination. Therefore, safety concerns did not justify the low vaccination rates. Inactivated influenza vaccine can be safely and effectively administered during any trimester of pregnancy, third-trimester vaccination being most beneficial for both mother and newborn. Educating pregnant women on vaccination safety and efficacy should help increase vaccination rates and decrease maternal hospitalization rates. Furthermore, increased vaccination rates should increase H1-specific passive antibody titers and decrease episodes of respiratory illness with fever in newborns.

Item Type: Thesis (Colloquium)
Supervisor nameSupervisor E mail
Degree programme: Medical Pharmaceutical Sciences
Thesis type: Colloquium
Language: English
Date Deposited: 24 Apr 2019
Last Modified: 30 Apr 2019 10:01

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