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Grand Rounds

Does Flu Vaccine During Pregnancy Have Long Term Adverse Effects on Children?

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BACKGROUND AND PURPOSE:

Previous studies have examined potential adverse effects of the pandemic A(H1N1) vaccine on pregnancy and birth outcomes.

  • No link has been found between the A(H1N1) vaccine and major pregnancy and birth adverse outcomes during pregnancy or in the perinatal period
  • Guidelines recommend that all pregnant women should be offered the flu vaccine
  • Limited data on potential effects beyond the perinatal period
  • This study by Hviid et al. (JAMA Pediatrics, 2017) sought to determine if vaccination with A(H1N1) flu vaccine during pregnancy increased the risk for early childhood morbidity in offspring

METHODS:

  • Register-Based Cohort Study
  • Live-born singleton children born in Denmark between November 2, 2009-March 31, 2010 were included in the survey
  • The vaccine was the monovalent inactivated AS03-adjuvanted split virion influenza A(H1N1)pdm09 vaccine (Pandemrix; GlaxoSmithKline Biologicals)

RESULTS:

  • 61,359 children included with a mean follow up of 4.6 years
    • 55,048 – unvaccinated mothers
    • 349 – mothers vaccinated during the first trimester
    • 5,962 – mothers vaccinated during the second and third trimesters
  • Children exposed to the vaccine in the first trimester did not have higher rates of hospitalization during early childhood than their unexposed
  • Children exposed to the vaccine in the second and third trimesters did not have higher rates of hospitalization in early childhood than their unexposed counterparts
    • Rather, there was a 7% decrease in risk due to reduced risk for infectious disease-related hospitalization

CONCLUSION:

  • This large, comprehensive study found no risk of increased early childhood morbidity following of exposure to the A(H1N1) flu vaccine during pregnancy
  • The data support guidelines that routine influenza vaccination is recommended for all women who are or will become pregnant (in any trimester) during influenza season

Learn More – Primary Sources:

Association Between Pandemic Influenza A(H1N1) Vaccination in Pregnancy and Early Childhood Morbidity in Offspring

 

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Related ObG Topics:

Do Neuraminidase Inhibitors Used for Flu Impact Neonatal Outcomes?
Vaccination in Pregnancy: CDC Recommendations and ACOG Update

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