Influenza vaccination during pregnancy

Within New Zealand, influenza vaccination coverage of pregnant women has been very modest. Research has identified that the most significant barriers to vaccination during pregnancy are –

     • A lack of information about:
            - influenza disease and potential complications, and
            - the “two for one” benefit of maternal influenza vaccination
     • No recommendation from the woman’s Lead Maternity Carer or other healthcare professionals involved in her care
     • Structural barriers to accessing services through general practice

There is considerable research to show that patients value the recommendation of their health professional. Studies also show the importance of an explanation covering the risks associated with influenza disease, the effectiveness of vaccination for the woman and her baby, and the excellent safety record of influenza vaccination during pregnancy during the decision-making process.

In 2018, some community pharmacies will provide funded influenza vaccination to pregnant women.

Influenza vaccination of pregnant women is recorded on the NIR to help monitor vaccination coverage and assess influenza protection. Refer to the section Recording influenza vaccinations on the National Immunisation Register.

Questions and answers for pregnant women

Is INFLUVAC® TETRA the funded influenza vaccine for pregnant women?
Yes. One dose of the inactivated quadrivalent influenza
vaccine is recommended each influenza season/year that a
woman is pregnant. A woman who is pregnant across two
influenza seasons would receive two influenza vaccinations
during her pregnancy.

Is there a minimum interval between receiving an influenza vaccination at the end of 2017 and receiving one in 2018?
No. The 2018 influenza vaccination can be given as soon as the vaccine is available. No minimum time is required between an influenza vaccination in 2017 and one in 2018.

Why is an influenza vaccination recommended every year?
Yearly vaccination is recommended for two reasons: first, because protection from the previous vaccination lessens over time; and second, because the circulating influenza viruses can change and the strains in the vaccine usually change each year in response to the changing virus pattern. 

Women who are pregnant across two influenza seasons are recommended to have an influenza vaccination in both of the seasons. In addition to the reasons explained above, a pregnant woman’s risk from influenza also increases with increasing gestation.

When is the best time to be vaccinated?
Influenza vaccination can be given at any time during pregnancy. It is preferable to vaccinate as soon as the vaccine is available (usually from March), well before the start of winter. The funded vaccine is available through to 31 December.

Can influenza and whooping cough booster vaccinations be given at the same visit?
If the woman is between 28–38 weeks of pregnancy (in their third trimester) the influenza vaccine and whooping cough booster vaccine (Tdap) can be administered at the same visit. Both vaccines are funded for pregnant women.

Can women with a history of miscarriage receive an influenza vaccination?
Yes. Influenza vaccination does not increase the risk of miscarriage. However, catching influenza can increase the risk.

Can a post-partum woman receive an influenza vaccination? Will it protect her baby if she is breastfeeding?
It is safe for a breastfeeding woman to have the influenza vaccination. Breastfeeding may offer some initial influenza protection to her baby. However, babies will have more protection if their mother is vaccinated during pregnancy.

Is the influenza vaccine a live vaccine?
No. The influenza vaccine used in New Zealand does not contain any live viruses; the influenza viruses are completely inactivated and cannot cause influenza.

Are there any preservatives in the influenza vaccine, e.g. thiomersal?
No. The vaccine used in New Zealand is preservative free. 

Should pregnant women who work with children receive an influenza vaccination?
Yes. Influenza infection rates are generally highest in children, and they are a major source of the spread of influenza. The influenza virus may be found in respiratory secretions (breathing, coughing and sneezing) for two weeks or longer in children. The risk of exposure to the influenza virus is higher and, for pregnant women, so is their risk of influenza disease and serious complications.

It is also important for all people working with children, and especially young babies, to be vaccinated against influenza to reduce the risk of passing influenza onto them.

Vaccination and breastfeeding

The influenza vaccine can be given to a breastfeeding woman. Protecting the mother can help prevent her becoming infected and transmitting influenza to her baby. Breastfeeding may offer some protection against influenza.