Published: 13 December 2018

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Influenza Immunisation in Pregnant Women

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Prescriber Update 39(4): 59
December 2018

Background

Influenza is an acute respiratory infection caused by influenza viruses. Vaccines are the most effective way to prevent infection and severe outcomes caused by these viruses¹ . The influenza (‘flu’) vaccine is especially important for people at risk of serious complications from influenza, including people aged 65 years and older, individuals with certain medical conditions, and pregnant women. For these people, influenza immunisation in New Zealand is free² .

Immunisation during pregnancy

Influenza immunisation is strongly recommended for women who will be (or intend to be) pregnant during autumn and winter. New Zealand research shows that pregnant women are nearly five times more likely to be hospitalised with influenza than women who are not pregnant³ .

Influenza immunisation during pregnancy offers protection to the neonate through maternal antibody transfer⁴ . Influenza vaccines are not approved for infants aged under 6 months, so vaccination during pregnancy offers protection to newborns and infants who are too young to have been vaccinated at the time of exposure to the virus⁴ . Influenza vaccination during pregnancy has been shown to significantly decrease influenza infection in infants up to 6 months of age⁴ .

The influenza vaccine is safe to administer during any trimester of pregnancy or while breastfeeding⁴ .

Pregnant women can receive free influenza vaccine at their general practice or from some community pharmacies.

Influenza vaccines for 2019

The recommended composition of influenza virus vaccines for use in New Zealand for the 2019 influenza season is now available⁵ . The proposed trivalent and quadrivalent vaccines introduce a new A (H3N2)-like virus strain and a new strain for the B Victoria lineage when compared to the composition of the influenza vaccines used in New Zealand in 2018.

Medsafe will work with suppliers of the influenza vaccines for the 2019 season to ensure the data sheets contain clear guidance around the use of the influenza vaccine during pregnancy and/or breastfeeding.

Note that, from approximately December 2018 to February 2019, there may be two data sheets published on the Medsafe website for each influenza vaccine: one for the 2018 influenza season and one for the 2019 season (www.medsafe.govt.nz/Medicines/infoSearch.asp).

References

1. World Health Organization. Influenza. URL: www.who.int/influenza/en/ (accessed 23 October 2018).
2. Immunisation Advisory Centre. 2018. Eligbility criteria. URL: www.influenza.org.nz/eligibility-criteria (accessed 23 October 2018).
3. Immunisation Advisory Centre. Immunisation is free for pregnant women. URL: www.fightflu.co.nz/pregnancy (accessed 23 October 2018).
4. Ministry of Health. 2018. Immunisation Handbook 2017 (2nd ed, March 2018). URL: www.health.govt.nz/publication/immunisation-handbook-2017 (accessed 23 October 2018).
5. 2018. Influenza vaccine composition. URL: www.medsafe.govt.nz/regulatory/flu.asp (accessed 23 October 2018).