In a recent committee statement, the American College of Obstetricians and Gynecologists (ACOG) strongly advocates for the annual influenza vaccination of pregnant individuals, emphasizing the elevated risks associated with complications for both the mother and the developing fetus.
The committee, including experts from ACOG and the Centers for Disease Control and Prevention (CDC), underscores the heightened susceptibility of pregnant and postpartum individuals to serious complications arising from both seasonal and pandemic influenza infections. Dr. Laura E. Riley, a member of ACOG’s Immunization, Infectious Disease, and Public Health Preparedness Expert Work Group, and chair of obstetrics and gynecology at Weill Cornell Medicine, highlights the increased risk, particularly when underlying health conditions are present.
The key recommendations from the committee are as follows:
Influenza Vaccination Guidelines:
All adults should receive an annual influenza vaccine.
Pregnant individuals, or those planning to conceive during the influenza season, are advised to receive inactivated or recombinant influenza vaccines.
Administration of other inactivated or non-virus-containing vaccines is encouraged during pregnancy if aligned with the influenza vaccine schedule.
Obstetricians, gynecologists, and healthcare professionals should actively recommend the influenza vaccine, providing counsel on its advantages for both pregnant women and their newborns.
Assessment and Treatment of Respiratory Infections in Pregnancy:
Clinicians should consider both influenza and SARS-CoV-2 infections when pregnant women present with respiratory illness symptoms.
Immediate initiation of empiric antiviral treatment is recommended for pregnant women with suspected influenza, preferably within 48 hours of symptom onset.
Patients with moderate risk for severe illness should undergo an in-person evaluation immediately.
High-risk patients should be seen in an emergency department or an equivalent setting without delay.
No postponement in antiviral treatment while awaiting test results for respiratory infections.
If there is suspected or confirmed coinfection with influenza and SARS-CoV-2, prescription of both oseltamivir and nirmatrelvir/ritonavir (Paxlovid, Pfizer) is advised.
The committee stresses the importance of addressing disparities in influenza vaccination rates, particularly among adults from historically underrepresented groups. Utilizing culturally responsive language, partnering with community groups, and relying on trusted messengers are identified as essential strategies to boost vaccination rates in these communities.
The committee’s concluding remarks emphasize the critical role of timely assessment and treatment in improving outcomes for pregnant patients. Obstetricians, gynecologists, and other obstetric care professionals are urged to play a proactive role in reducing disparities in influenza vaccination rates and mitigating severe outcomes related to influenza infection by strongly recommending influenza vaccination to all patients.
