Grand Rounds

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

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

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)

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

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

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