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Maternal flu shots protect newborns

AlaskaDenise

In Memoriam
By Gene Emery

BOSTON (Reuters) - Flu shots given to pregnant women a month or more before delivery will prevent most cases of influenza during the first six months of their babies' lives, researchers said.

"Immunize the mother and you protect the infant," Dr. Mark Steinhoff, a pediatrician with the Johns Hopkins University Bloomberg School of Public Health, said in a telephone interview.

The shots are not licensed for children younger than six months old -- who are in turn more likely to be hospitalized for influenza than any other group.

In the test of 340 pregnant women in Bangladesh, the shots cut the risk of flu by 63 percent and the risk of respiratory illness overall by 29 percent. There were six confirmed cases of influenza in the vaccinated group, compared to 16 among the mothers given a different vaccine.

The injections also lowered the likelihood of fever and respiratory illness among the mothers by 36 percent.

Doctors have known for years that immunizations given to a woman can protect her newborn, so there was no reason to believe the flu vaccine would not work the same way, said Steinhoff. "We always assumed it, but nobody's done the study before," he said.

Flu shots have been recommended for pregnant women by the U.S. Centers for Disease Control and Prevention since 1997, but the advice has been widely ignored, he said. The new study, published in the New England Journal of Medicine, may change that.

"This might persuade more mothers to say, 'Hey, it really helps me and it really helps the baby,'" Steinhoff said.

Only 15 percent of pregnant U.S. women receive the vaccine each year.

The vaccinations in the Bangladesh study were given during the third trimester because in 2004 and 2005, "at the time we did the study, that was the recommendation," he said.

The current advice to pregnant women is to get the vaccine during the flu season, although it takes about a month for the protection to build in the baby. (Editing by Maggie Fox and Cynthia Osterman)

http://www.reuters.com/article/healthNews/idUSN1726328620080917
 
Re: Maternal flu shots protect newborns

Published at www.nejm.org September 17, 2008 (10.1056/NEJMoa0708630)

<!-- AUTHOR_DISPLAY --><CENTER>K. Zaman, M.B., B.S., Ph.D., Eliza Roy, M.B., B.S., D.C.H., Shams E. Arifeen, M.B., B.S., Dr.P.H., Mahbubur Rahman, M.B., B.S., Ph.D., Rubhana Raqib, Ph.D., Emily Wilson, M.H.S., Saad B. Omer, M.B., B.S., Ph.D., Nigar S. Shahid, M.B., B.S., M.P.H., Robert E. Breiman, M.D., and Mark C. Steinhoff, M.D. </CENTER><CENTER> </CENTER>
ABSTRACT
[FONT=arial, helvetica]Background Young infants and pregnant women are at increased<SUP> </SUP>risk for serious consequences of influenza infection. Inactivated<SUP> </SUP>influenza vaccine is recommended for pregnant women but is not<SUP> </SUP>licensed for infants younger than 6 months of age. We assessed<SUP> </SUP>the clinical effectiveness of inactivated influenza vaccine<SUP> </SUP>administered during pregnancy in Bangladesh.<SUP> </SUP>[/FONT]
[FONT=arial, helvetica]<SUP></SUP>
Methods In this randomized study, we assigned 340 mothers to<SUP> </SUP>receive either inactivated influenza vaccine (influenza-vaccine<SUP> </SUP>group) or the 23-valent pneumococcal polysaccharide vaccine<SUP> </SUP>(control group). Mothers were interviewed weekly to assess illnesses<SUP> </SUP>until 24 weeks after birth. Subjects with febrile respiratory<SUP> </SUP>illness were assessed clinically, and ill infants were tested<SUP> </SUP>for influenza antigens. We estimated the incidence of illness,<SUP> </SUP>incidence rate ratios, and vaccine effectiveness.<SUP> </SUP>
<SUP></SUP>
Results Mothers and infants were observed from August 2004 through<SUP> </SUP>December 2005. Among infants of mothers who received influenza<SUP> </SUP>vaccine, there were fewer cases of laboratory-confirmed influenza<SUP> </SUP>than among infants in the control group (6 cases and 16 cases,<SUP> </SUP>respectively), with a vaccine effectiveness of 63% (95% confidence<SUP> </SUP>interval [CI], 5 to 85). Respiratory illness with fever occurred<SUP> </SUP>in 110 infants in the influenza-vaccine group and 153 infants<SUP> </SUP>in the control group, with a vaccine effectiveness of 29% (95%<SUP> </SUP>CI, 7 to 46). Among the mothers, there was a reduction in the<SUP> </SUP>rate of respiratory illness with fever of 36% (95% CI, 4 to<SUP> </SUP>57).<SUP> </SUP>
<SUP></SUP>
Conclusions Inactivated influenza vaccine reduced proven influenza<SUP> </SUP>illness by 63% in infants up to 6 months of age and averted<SUP> </SUP>approximately a third of all febrile respiratory illnesses in<SUP> </SUP>mothers and young infants. Maternal influenza immunization is<SUP> </SUP>a strategy with substantial benefits for both mothers and infants.<SUP> </SUP>(ClinicalTrials.gov number, NCT00142389<!-- HIGHWIRE EXLINK_ID="0:2008:NEJMoa0708630v1:1" VALUE="NCT00142389" TYPEGUESS="CLINTRIALGOV" --> [ClinicalTrials.gov] <!-- /HIGHWIRE -->.)<SUP> </SUP>
[/FONT]
[FONT=arial, helvetica][SIZE=+1]Source Information[/SIZE][/FONT]
From the International Centre for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z., E.R., S.E.A., M.R., R.R., N.S.S., R.E.B.); and the Bloomberg School of Public Health (E.W., S.B.O., M.C.S.), Institute for Vaccine Safety (S.B.O.), and Department of Pediatrics, School of Medicine (M.C.S.) ? all at Johns Hopkins University, Baltimore. <SUP></SUP>
<SUP></SUP>
This article (10.1056/NEJMoa0708630) was published at www.nejm.org on September 17, 2008. It will appear in the October 9 issue of the Journal.

Address reprint requests to Dr. Steinhoff at the Children's Global Health Center, Cincinnati Children's Hospital, 3333 Burnet Ave., MLC 2048, Cincinnati, OH 45229, or at m.steinhoff@gmail.com<SCRIPT type=text/javascript><!-- var u = "m.steinhoff", d = "gmail.com"; document.getElementById("em0").innerHTML = '<a href="mailto:' + u + '@' + d + '">' + u + '@' + d + '<\/a>'//--></SCRIPT> .

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