Monday, March 18, 2013

COVRAC Guest blog: Influenza vaccination during pregnancy


We are very grateful to COVRAC, the author of today's guest post, who can be found over at his Facebook page "Chillin' Out, Vaxin', Relaxin' All Cool.
Seasonal influenza disease is dangerous to both a pregnant mother and the fetus. This is generally not in dispute, even by the most staunch antivaxers. But get about three Facebook comments into a discussion over flu shots for pregnant women (perhaps one that goes something like this, and invariably your self-proclaimed educated opponent with tell you in no uncertain terms that influenza vaccine has never been studied in pregnancy.
Well, then. Let's go over the numerous studies of influenza vaccines in pregnant women that have, it is claimed, never been done.

These studies have allegedly never been done on seasonal influenza vaccine in pregnant women. If they had been done, they would clearly demonstrate it to be safe.
http://www.ajog.org/article/S0002-9378(04)02102-7/abstract
http://www.ncbi.nlm.nih.gov/pubmed/20715555

These were apparently never done on the H1N1 vaccine. It would also have been clearly demonstrated to be safe (if they had been done).
http://www.ncbi.nlm.nih.gov/pubmed/20832495
http://www.ncbi.nlm.nih.gov/pubmed/21596080
http://idsa.confex.com/idsa/2010/webprogram/Paper3534.html
http://www.ajog.org/article/S0002-9378(11)00775-7/abstract

This study which obviously was never done showed far less premature births in mothers vaccinated during pregnancy.
http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000441;jsessionid=8B7B450C63F7196BE157DB7629B57432.ambra02

This other totally undone study looked specifically at miscarriages in women vaccinated in the first trimester, and did not find an increased risk.
http://idsa.confex.com/idsa/2011/webprogram/Paper30513.html

This one, which might look like a study showing decreased fetal deaths in the H1N1-vaccinated, is really just a bunch of fancy words meaning "404 page not found."
http://www.nejm.org/doi/full/10.1056/NEJMoa1207210

This study in the Canadia Medical Association Journal found that pregnancies during influenza season resulted in higher birth weight and less premature birth if the mother was vaccinated against influenza. But you can sooo tell it is CG and not real.
http://www.cmaj.ca/content/early/2012/02/21/cmaj.110754

These figments of your imagination show how influenza vaccination of pregnant mothers protects newborns from influenza.
http://archpedi.ama-assn.org/cgi/content/short/archpediatrics.2010.192
http://www.ncbi.nlm.nih.gov/pubmed/21058908
http://www.nejm.org/doi/full/10.1056/NEJMoa0708630

And finally, this indigestion-induced hallucination here from the American Journal of Obstetrics & Gynecology is a list of studies on the safety of influenza vaccine dating back to 1964. As Scrooge would say, "You may be an undigested bit of beef, a blot of mustard, a crumb of cheese, a fragment of an underdone potato."
http://www.influenza.org.nz/site_resources/Influenza/Influenza%202010/Safety_of_influenza_vaccination_during_pregnancy.pdf#page=2

Back to reality: These studies have, in fact, been done. An antivaxer will fall back to quoting a vaccine package insert, but it's evident that such a document does not reflect the entirety of the world's research on a given vaccine. Influenza vaccination in pregnancy has been studied in abundance. A flu shot is safe during pregnancy (without a known medical contraindication), does not cause miscarriage, and protects the health of pregnant women and their babies.

16 comments:

  1. Thank you both for lending me your audience! I'm going to try not to get all Wayne's World "I'm not worthy! I'm not worthy!" on you.

    Oops, too late.

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  2. Great post! I was contaminated by anti-vaxers about 4years ago, when I was pregnant with my 1st son. It made me delay vaccines and adopt a crazy schedule. Thankfully I never stopped researching and changed my mind. I ended up fully vaccinating and with my 2nd son I followed the recommended schedule.
    However, my anti-vaxer times made a huge damage in my trust. When pregnant for the 2nd time, I didn't have the confidence in vaccines to get a flu shot. Maybe if I'd read something like this at that time, things would have been different.
    So, a great source of information for pregnant ladies!

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  3. Thanks, Camilla! Please do share with any friends who need it. And if any other questions about vaccines come up, stop by the Facebook page.

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  4. Brilliant post COVRAC! You are worthy! You are worthy!

    Hi to Camilla.

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    1. Thank you, Lilady! That means a lot to me from a battle-hardened woo fighter like yourself.

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  5. Thank you for your excellent post.
    Influenza vaccinations should be within a programm "prepare for pregnancy".

    But you forgot some studies related to the risk of schizophrenie when an influenca infection happens during the 1st trimester.

    Brown AS published some studies about the association of influenza infection with schizophrenia in the 1st trimester.

    http://www.ncbi.nlm.nih.gov/pubmed/22488761

    this findings are now supported by Lucchese G et al

    http://www.ncbi.nlm.nih.gov/pubmed/23378012

    they found a peptide sharing beetwenn influenza peptides and human axon guidance proteins

    http://www.ncbi.nlm.nih.gov/pubmed/22488761

    in addition hyperthermia (fever) is normal during influenza infection, but fever is the first well known teratogen (in humans and animals) and can cause neural tube defects during early pregnancy (day 21-27)

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    1. Thanks, Wolfgang. There are a number of studies regarding adverse outcomes of influenza infection in pregnancy, that by way of prevention vaccination may reduce. I just focused on the studies that actually looked at pregnant women and vaccination status.

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  6. Hi Catherina/Science Mom/JustTheVax,

    great blog with good insights. Thanks for all your effort.

    Since you are obviously very knowledgeable on the subject I have a question, or maybe several...

    What is your best guess about our world 50 to 100 years from now from a vaccination perspective? Will we have eradicated most deceases? Will we be fighting new ones with vaccines? Will the vaccination schedule have grown to 120 shots or decreases to 3 or 4? Will vaccines have been replaced by nano tech? I'd like to have your thoughts in this.

    Many thanks in advance.
    Reg

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  7. Reg, it's so hard to make predictions but I can make an educated guess that no, we won't see a vaccination schedule with 120 jabs, nor 3 or 4. I can see measles and possibly rubella eradicated. Yes we will see the emergence of new diseases and changes in the epidemiology of existing pathogens as our ecosystems change.

    I also see major changes in vaccine technology in terms of antigens, delivery systems and adjuvants. Safety and efficacy will be improved as we gain more knowledge of the human genome and proteonome.

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  8. Wow, thanks for the quick reply.

    I'm a from-the-moon perspective type of person. So forgive me for a final off-topic question. I'd like your thoughts on the moral front.

    Internet is littered with mentions of $billions big pharma fines, for all kinds of misconduct. The same companies that make our vaccines...

    If my next door neighbor lied, I would consider him unreliable. How is that different for these companies? Are these reports even true? Am I apple-pearing here or missing something? How should the average person look at this?

    Again, many thanks for your thoughts,
    Reg

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    Replies
    1. If my next door neighbor lied, I would consider him unreliable. How is that different for these companies? Are these reports even true? Am I apple-pearing here or missing something? How should the average person look at this?

      Yes, the multi-billion fines levied on pharma companies are indeed true. They are always for therapeutic drugs (as opposed to biologicals like vaccines) and usually due to dodgy advertising, clinical studies and creative prescribing suggestions.

      While it seems to logically follow that pharma may be doing something dodgy with regards to vaccines, it just isn't the case. Vaccines, with the exception of a couple blockbusters like Prevnar and HPV don't make money for pharma but have a steady demand with no need for advertising (again, with the exception of say HPV). Vaccines are also administered to healthy people for prevention, not to sick people for a therapeutic. That means that they have to have a much higher safety profile and are much more tightly regulated. In short, there is neither the incentive nor the opportunity for the dodgy conduct you read regarding other drugs and practices.

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    2. What a great answer. Indeed, I did read that vaccines have no margin. You (guys/girls) are worth your weight in gold, and it shows in the depth and scope of your blog. Keep up the good work, and thanks again.
      Reg.

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  9. Spammer Alert Above.

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    Replies
    1. it is the funniest thing how the spammers produce word salad that almost reads like an on topic response!

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  10. So, should you advise the flu shot for every pregnant woman as a conclusion to all that research? In The Netherlands only women with heart and lung diseases, with diabetes and with a low functioning immune system (lage weerstand; don't know how to translate) get the free flu shot.
    I always find it interesting how vaccines differ per country. For instance in Belgium they give a rotavirus vaccine, while in the Netherlands they do not. How does that work?

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