H1N1 influenza vaccination during pregnancy is not associated with pediatric problems

  • BMJ

  • de Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
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Takeaway

  • Receipt of the 2009 H1N1 vaccination during pregnancy is not associated with any serious pediatric complications.

Why this matters

  • All pregnant women are advised to get immunized against influenza to prevent maternal complications and provide passive immunity to infants.
  • Uptake of influenza vaccination during pregnancy has been low because of perceived safety concerns.

Key results

  • 30% of cohort received vaccination.
  • No association was identified between vaccination and pediatric infections, neoplasms, sensory disorders, health care use, pediatric complex chronic conditions, or mortality up to age 5 years.
  • A small increase in pediatric asthma risk was seen: adjusted HR, 1.05 (95% CI, 1.02-1.09).
  • Also, a small decrease in gastrointestinal infections: adjusted incidence rate ratio, 0.94 (95% CI, 0.91-0.98).

Study design

  • Retrospective cohort study.
  • Cohort identified from a population-based birth registry linked with a Canadian health administrative database (n=104,249).
  • Exposure of interest was receipt of the 2009 H1N1 influenza vaccination during pregnancy (n=31,295).
  • Children who were in utero during maternal vaccination were followed to age 5 years.
  • Funding: the Canadian Institutes of Health Research and by ICES, which is funded by an annual grant from the Ontario Ministry of Health and Long term Care.

Limitations

  • Cohort followed only 5 years.
  • Vaccinations change yearly.