A: YES! The flu vaccine protects against the higher risk of severe flu disease during pregnancy AND protects the newborn from flu during the first few months of life.
TL;DR: Flu season looks especially bad this year. Influenza (“the flu”) vaccination is strongly recommended in pregnancy. Because the virus is seasonal, vaccination is recommended as soon as the vaccine becomes available, rather than at a specific time in the pregnancy. It can be received in all trimesters and will help protect both the pregnant person and the infant after birth.
Influenza Infection during pregnancy is more dangerous than when not pregnant. Pregnant individuals have higher rates of hospitalization, intensive care admission, and death from flu compared to the general population. While passing flu to your baby while pregnant is rare, infection can lead to increased risk of preterm birth, low birth weight, and even pregnancy loss. Vaccination decreases the risk of influenza infection and reduces the severity of illness if infection does occur.
In addition to protecting the pregnant person, protective antibodies from vaccination cross the placenta to the fetus. This protects an infant for up to six months after birth. This is particularly important since the youngest babies are most at risk of severe disease from respiratory viruses like the flu. Babies cannot be vaccinated until six months, so this passive immunity is important to protect them after birth.
While vaccination is the single best protection against the flu for pregnant people, other harm reduction strategies can help. Like any respiratory virus, avoiding contact with people who are sick, washing hands frequently, and avoiding touching your face can decrease transmission. Consider masking in high-risk situations to further decrease risk (see recent post on masking sometimes: https://dearpandemic.org/mask-sometimes/).
If you get the flu while pregnant or have a known high-risk exposure, you should speak to your clinician. Antiviral medications can be given in pregnancy and may be an option in those situations.
Other vaccines? In addition to the flu vaccine, Tdap (tetanus, diphtheria, pertussis) and COVID vaccines are also recommended in pregnancy. Tdap is recommended specifically for the “p”, which stands for pertussis, or “whooping cough.” Most of the severe disease and deaths from whooping cough occur in newborns under 3 months of age. Vaccination in the third trimester of each pregnancy passes on important antibodies to decrease this risk.
COVID vaccination continues to be recommended for all pregnant and recently pregnant individuals. Like flu, this should be given if it has not been received prior to pregnancy or if due for bivalent booster, regardless of gestational age. It can be given in any trimester. For both primary series and booster, mRNA COVID-19 vaccines are preferred.
Flu, COVID, and Tdap vaccines are safe to be given at the same time. Flu and covid vaccines are recommended as soon as available/eligible. Tdap should be given between 28-36 weeks to ensure ideal passive immunity for the baby.
Flu season has ramped up early this year, with reports of more severe disease than normal. This is of particular concern for pregnant individuals and their babies, who both are at increased risk. Vaccination is safe and strongly recommended in pregnancy to decrease that risk.
Stay safe, stay well, get vaccinated!
Those Nerdy Girls
ACOG, Vaccine Recommendations and Safety in pregnancy