Tag: miscarriage

Is Measles Dangerous If You Are Pregnant?

While folks often try and make it seem like measles is a common childhood illness, we know that it can be dangerous.

“One of the patients was a 20-year-old pregnant woman who had rash onset on January 5 following exposure to her 12-year-old brother. After delivering a healthy baby on January 6, the mother developed severe pneumonia that was followed by respiratory arrest. She was resuscitated and transferred to an intensive care unit in a larger hospital nearby in Tennessee.”

Epidemiologic Notes and Reports Transmission of Measles Across State Lines — Kentucky, New Hampshire, Tennessee, Virginia

Rarely do people who have really had measles describe it as just a fever and a rash. They remember that it was called a harmless killer for a reason.

Is Measles Dangerous If You Are Pregnant?

And there are some situations in which measles can be especially dangerous, including if you get sick when you are very young, very old, or have immune system problems.

Pregnant women should be screened for measles immunity.
Pregnant women should be screened for measles immunity.

And what if you are pregnant when you get measles?

“The Health Department announced today that the number of measles cases has grown to 390, including two pregnant women diagnosed with the infection, one diagnosed in mid-April.”

The Number of Measles Cases Grows to 390

If you are pregnant and you are exposed to someone with measles, you can get IVIG post-exposure prophylaxis to prevent you from actually getting measles, but this typically only works if given within six days of the exposure.

“To date, studies have not identified an increased risk for birth defects when pregnant women get the measles during pregnancy. However, studies suggest that measles infection is associated with an increased risk for miscarriage, stillbirth, prematurity and the baby being born with a measles infection.”

When Measles Strike, It’s Not The Happiest Place On Earth For Pregnant Women

Unlike a rubella infection during pregnancy, a measles infection is not thought to cause birth defects. Tragically, it can, like rubella, lead to an increased risk for having a miscarriage.

“Infants who develop congenital measles are at increased risk for mortality and for subacute sclerosing panencephalitis, which is more common when measles is diagnosed in infancy. In addition, subacute sclerosing panencephalitis in newborns infected with measles either congenitally or shortly after birth appears to be more severe, with a shorter latency and rapidly progressive course.”

What Obstetric Health Care Providers Need to Know About Measles and Pregnancy

And if the mother gets measles very late in her pregnancy, it can also lead to a case of congenital measles, or a baby being born with an active measles infection.

“In 52% of cases, measles was likely acquired from a relative. Complications included pneumonia in one child; two pregnant women required hospitalization, including one who miscarried.”

Notes from the Field: Measles Outbreak Among Members of a Religious Community — Brooklyn, New York, March–June 2013

Don’t take the risk that you might get measles while you are pregnant.

Make sure you are vaccinated and protected before you ever start thinking about getting pregnant, as pregnancy is a contraindication to getting the MMR vaccine. And you should wait at least 4 weeks after getting vaccinated before getting pregnant.

More on Measles in Pregnancy

Did the FDA Admit That the Government Is Recommending Untested, Unlicensed Vaccines for Pregnant Women?

Have you heard?

There is a new bombshell from anti-vaccine folks!

It turns out, they say, that the FDA has admitted that the government is recommending untested, unlicensed vaccines for pregnant women.

Is that true?

Did the FDA Admit That the Government Is Recommending Untested, Unlicensed Vaccines for Pregnant Women?

Of course not!

Their evidence?

A response to a Freedom of Information Act request for vaccines that don’t exist. That’s right, neither Tdap nor flu vaccines are currently FDA approved for use by pregnant women.

Of course, that doesn’t mean that Tdap and flu vaccines aren’t recommended for use by pregnant women.

Wait, why the difference?

Why are pregnant women being given a vaccine that isn’t formally FDA approved for their use?

Well, vaccine manufacturers have to seek FDA approval for their products. The FDA doesn’t just up and approve new products or give them new indications. And none have ever sought approval in pregnancy.

But that doesn’t keep health experts from making off-label recommendations, such as getting a flu vaccine when you are pregnant.

“In prelicensure evaluations, the safety of administering a booster dose of Tdap to pregnant women was not studied. Because information on use of Tdap in pregnant women was lacking, both manufacturers of Tdap established pregnancy registries to collect information and pregnancy outcomes from pregnant women vaccinated with Tdap. Data on the safety of administering Tdap to pregnant women are now available.”

Updated Recommendations for Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine (Tdap) in Pregnant Women and Persons Who Have or Anticipate Having Close Contact with an Infant Aged <12 Months — Advisory Committee on Immunization Practices (ACIP), 2011

As important as FDA approval is a recommendation from the Advisory Committee on Immunization Practices (ACIP). In fact, even after a vaccine gets approved by the FDA, it still has to get a recommendation from the ACIP before it gets on the immunization schedule and is used routinely!

“Flu shots have been given to millions of pregnant women over many years with a good safety record. There is a large body of scientific studies that supports the safety of flu vaccine in pregnant women and their babies.”

Flu Vaccine Safety and Pregnancy

Getting a flu vaccine during pregnancy is a recommendation that has been evolving since 1983. It was known to be safe then, and we are even more confident that it is safe now.

A Tdap shot has been recommended since 2011, although it was first suggested in 2008 that pregnancy was not a contraindication for receiving Tdap.

How do we know these vaccines are safe during pregnancy?

The Vaccine Safety Datalink has published more than 14 studies “related to pregnancy and vaccination during pregnancy” and has used “data to study the health of children born to women who were vaccinated during pregnancy.”

Despite what Robert F. Kennedy, Jr and his ironically named Children’s Health Defense organization might think, Tdap and flu shots in pregnancy have been well studied and have been found to be safe.

Ignoring all of the above studies, Kennedy highlights a few that he thinks found problems with flu shots in pregnancy, including one that showed “a suggestion of increased ASD risk among children whose mothers received an influenza vaccination in their first trimester,” a suggestion that was not statistically significant and which was not found in the other trimesters. And another that found an increased risk of spontaneous abortion in women who had also received a flu shot in the previous season, a safety signal that has never been seen before and which continues to be investigated.

Not surprisingly, his latest bombshell is landing with as big of a thud as his HHS lawsuit, as have most of his statements these days…

“CHD’s Chairman Robert F. Kennedy, Jr. notes that most flu shots given to pregnant women still contain a mercury-based preservative thimerosal.”

FDA Admits That Government Is Recommending Untested, Unlicensed Vaccines for Pregnant Women

Has Kennedy missed the fact that 80% of flu vaccines are now thimerosal free? It makes you wonder how he defines the word “most?”

“Thimerosal is acknowledged by Proposition 65 in California as a reproductive toxicant and exposure during pregnancy can cause learning and behavioral problems. Tdap contains aluminum, which FDA regulates as a toxin in parenteral nutrition but not in vaccines.”

FDA Admits That Government Is Recommending Untested, Unlicensed Vaccines for Pregnant Women

And what is he concerned about in thimerosal-free flu shots which also don’t contain aluminum? Are those okay in his book?

Mostly, after several flu seasons in which so many people have died, you have to wonder what his goal is here. Does Robert F. Kennedy, Jr. expect folks to skip getting a flu shot when they are pregnant and instead risk getting the flu? Should they skip their Tdap shot and risk their baby dying of whooping cough?

Or should they just stop listening to this type of anti-vaccine propaganda?

More on Did The FDA Admit That The Government Is Recommending Untested, Unlicensed Vaccines For Pregnant Women?

Vaccines in Pregnancy

Can children get vaccinated when their mother is pregnant?

Yes.

The CDC states that “pregnancy of recipient’s mother or other close or household contact” is not a contraindication to getting vaccinated, even for live vaccines like MMR or Varivax.

Vaccines for Pregnant Women

What about pregnant women?

Since infants can't get a flu shot until they are 6 months old, they rely on their pregnant mothers to get vaccinated and to pass on their protection to them.
Since infants can’t get a flu shot until they are 6 months old, they rely on their pregnant mothers to get vaccinated and to pass on their protection to them.

Are vaccines safe or necessary for them?

While they shouldn’t get live vaccines, like MMR, Varivax, Flumist, or the yellow fever vaccine, or the HPV vaccine, it is safe and necessary for pregnant women to get most other vaccines.

In fact, all pregnant women should get:

Getting vaccinated during pregnancy helps protect newborn babies and infants against the flu and pertussis (whooping cough).

Are Vaccines During Pregnancy Really Safe?

What about the idea that vaccines have never been tested for safety or effectiveness in pregnancy?

“Health care providers and patients should be aware that the reassuring safety data for use of the aforementioned vaccines in pregnancy are compelling, and there is no link to vaccine administration and miscarriage.”

ACOG on Vaccines Routinely Recommended during Pregnancy

The seasonal flu and Tdap vaccines, the two most commonly recommended are safe and effective in pregnancy. And so are the others that are not contraindicated.

In fact, the Vaccine Safety Datalink has published 14 studies “related to pregnancy and vaccination during pregnancy” and is “also able to use data to study the health of children born to women who were vaccinated during pregnancy.”

What About the Association of Flu Shots with Miscarriages?

You may have seen the headlines about a new study in which “Researchers find hint of a link between flu vaccine and miscarriage.”

Published in the journal Vaccine, the study did find that having a miscarriage “was associated with influenza vaccination in the preceding 28 days.”

The “modest” association only held during the 2010-12 flu seasons though and only if:

  • the mother had also received an H1N1 flu vaccine the previous year
  • the flu vaccine was given early in her pregnancy

The association was found by comparing two small groups of women who were pregnant during flu season, including one whose pregnancy ended in a miscarriage. They then compared the two groups to find differences. And the main difference they found was that the group with the miscarriages were more likely to have had a flu shot the previous year. So that is the link, association, or maybe more appropriately named – the correlation.

“This study does not quantify the risk of miscarriage and does not prove that flu vaccine was the cause of the miscarriage.”

CDC on Flu Vaccination & Possible Safety Signal

Interestingly, the study found no association between having a flu shot during the same season and having a miscarriage. The pregnant women in the control group were just as like to have flu shots, even early in their pregnancy.

It is also important to note that several other studies have not found an association between miscarriages and flu shots, including an almost identical study that looked at the 2005-07 flu seasons!

“A recent publication has reported a safety signal concerning influenza vaccination when given very early in the first trimester. In this study, influenza vaccination, when given in very early pregnancy, was associated with an increased risk of a pregnancy loss within the first 28 days following vaccination. Scientifically, it is unclear why this would occur. There was no association seen with a pregnancy loss more than 28 days after vaccination. In the same study, when vaccination was given either later in the first trimester or in the second or third trimester, there was no association seen with pregnancy loss or any other adverse pregnancy outcomes. Additional studies are needed to address the concern raised by this study.”

ACOG statement It is Safe to Receive Flu Shot During Pregnancy

So it is still safe to get a flu shot while you are pregnant, as this possible association continues to be studied. There are already ongoing studies looking at flu shots and pregnancy during the 2012 through 2015 flu seasons that will be completed next year.

“Two other medical journals rejected the article before a third, Vaccine, accepted it. Dr. Gregory Poland, Vaccine’s editor-in-chief, said it was a well-designed study that raised a question that shouldn’t be ignored. But he doesn’t believe flu shots caused the miscarriages. “Not at all,” said Poland, who also is director of vaccine research at the Mayo Clinic.

Though this study may cause worry and confusion, it is evidence “of just how rigorous and principled our vaccine safety monitoring system is,” said Jason Schwartz, a Yale University vaccine policy expert.”

AP report Study prompts call to examine flu vaccine and miscarriage

While most experts don’t think that getting a flu shot while you are pregnant is harmful, even considering this new study, they do know that getting the flu is.

What To Know About Vaccines During Pregnancy

When you are pregnant, getting your Tdap and flu vaccines can help keep you and your baby safe and healthy.

More Information on Vaccines During Pregnancy: