Influenza vaccination of women during pregnancy
GACVS discussed recommendations for the use of inactivated influenza vaccine in women during pregnancy and particularly during the first trimester. It was pointed out that manufacturers, as well as national regulatory authorities, tend to caution against routine use of influenza vaccine during pregnancy. Despite the paucity of data related to the use of influenza vaccines during the first trimester of pregnancy, other inactivated vaccines (e.g. tetanus) have proved safe in this context. There is concern that influenza during pregnancy carries a significantly higher risk of morbidity, hospitalization, and even of fatal outcome, comparable to that in persons aged 65 years and over. The risk of maternal influenza to the fetus is the same throughout pregnancy.
GACVS concluded that risk–benefit of influenza vaccination during pregnancy, at all stages of pregnancy, should be reconsidered, given the high risk to the mother – and thus to the fetus – of the disease itself, and (as far as is known) the small potential risk to mother and fetus of the inactivated influenza vaccine. WHO was advised of the view of the Committee accordingly. Such advice would not apply to situations where the risk of influenza is low or to live attenuated vaccines, which in any event would not be indicated in pregnancy.