Young children have a higher risk of complications if they become ill with influenza, compared with larger ones, but unfortunately no vaccine is approved for infants 0-6 months of age.
Even pregnant women in the second and third quarters of the people are at greater risk of complications from influenza and they are recommended to be vaccinated after the third month of pregnancy performed.
It is therefore important to find out if the woman becomes pregnant vaccinated against influenza indirectly protects the child, passing it (via the placenta before birth and mother's milk after) specific antibodies against the strains viruses responsible for infections in the months following childbirth. Even without the vaccine's maternal antibodies are transmitted to the baby born at term and circulate in your blood for several months. To these must be added that receives secretory IgA antibodies in breast milk. Unfortunately, the virus, especially those of influenza A, change frequently, and these antibodies may not be very secure because they are directed against the strains of previous seasons.
were recently published two studies whose aim was to examine whether vaccinating pregnant women who give birth shortly before or during the influenza season, the protection also extends to the child.
Arch Pediatr Adolesc Med. 2010 Oct 5
Maternal Influenza Vaccination and Effect on Influenza Virus Infection in Young Infant
Eikk AA, Uyki TM, Klimov A, Hall H, Reid R, Santosham M, O'Brien KL
E' uno studio non randomizzato , osservazionale di coorte , prospettico
A total of 1160 mother-child pairs with mothers who had given birth in one of the three influenza seasons studied (from November 2002 to September 2005) were included in the search. For children 0-6 months whose mothers were vaccinated against influenza during pregnancy
E' uno studio non randomizzato , osservazionale di coorte , prospettico
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Prima di proseguire con la lettura dell'articolo, Vi informo che dal 10.1.11, the Veneto Region has put online a questionnaire for parents about vaccinations.
Please participate and run the link as much as possible.
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A total of 1160 mother-child pairs with mothers who had given birth in one of the three influenza seasons studied (from November 2002 to September 2005) were included in the search. For children 0-6 months whose mothers were vaccinated against influenza during pregnancy
- risk influenza confirmed by laboratory had decreased by 41%,
- the risk of hospitalization for flu-like illness was reduced by 39%
At the time of birth and 2-3 months of age, children of mothers vaccinated against influenza had a higher level of antibodies against all eight strains of virus examined, when compared with children whose mothers had been vaccinated. The level of antibodies was associated with a reduction of laboratory-confirmed influenza.
The research involved women living in the reserve of the Navajo and White Mountain Apache, including six hospitals and Navajo Reservation one of the White Mountain Apache reservation. The children of these ethnic groups have a higher risk of acute respiratory infections in the general population of the USA.
The second study, more recently:
Clin Infect Dis. 2010 Dec 15; 51 (12) :1355-61. Epub 2010 Nov 8.
Influenza vaccine given to pregnant women to influence two Reduces hospitalization in infants Their
Benowitz I, Esposito DB, Gracey KD, Shapiro ED, M. Vázquez
This is a matched case-control study (matched case control study)
analysis were including 113 children under 1 year of age who were hospitalized with influenza (laboratory confirmed) at the "Yale-New Haven Children's Hospital in the United States between October 2000 and April 2009.
were selected for each case one or two subjects (total 192) who were hospitalized at the same hospital, but according to laboratory tests were positive for influenza virus. The subjects were matched for similar age and day of hospitalization = control group
L 'effectiveness of the vaccine given to the mother during pregnancy in the prevention of hospitalization for influenza (laboratory confirmed), adjusted for confounding variables was 91.5% for children under 6 months of age. In children between 6 and 12 months of age the effect was - 41.4%, which probably indicates a zero effect (because of the wide confidence interval )
course, the percentage of effectiveness resulting from these two studies should not be construed as carved in stone, because there is always the possibility of unknown confounding variables that were not taken into account when collecting and processing data. There are also other limitations that may have influenced questi risultati che verranno comunque inserite dagli esperti nel contesto generale (l'epidemiologia, i dati di altri studi del passato, la situazione in Europa etc.).
Segnalo l'articolo
Efficacia degli interventi sanitari: efficacy o effectiveness?
Influenza vaccine given to pregnant women to influence two Reduces hospitalization in infants Their
Benowitz I, Esposito DB, Gracey KD, Shapiro ED, M. Vázquez
This is a matched case-control study (matched case control study)
analysis were including 113 children under 1 year of age who were hospitalized with influenza (laboratory confirmed) at the "Yale-New Haven Children's Hospital in the United States between October 2000 and April 2009.
were selected for each case one or two subjects (total 192) who were hospitalized at the same hospital, but according to laboratory tests were positive for influenza virus. The subjects were matched for similar age and day of hospitalization = control group
L 'effectiveness of the vaccine given to the mother during pregnancy in the prevention of hospitalization for influenza (laboratory confirmed), adjusted for confounding variables was 91.5% for children under 6 months of age. In children between 6 and 12 months of age the effect was - 41.4%, which probably indicates a zero effect (because of the wide confidence interval )
course, the percentage of effectiveness resulting from these two studies should not be construed as carved in stone, because there is always the possibility of unknown confounding variables that were not taken into account when collecting and processing data. There are also other limitations that may have influenced questi risultati che verranno comunque inserite dagli esperti nel contesto generale (l'epidemiologia, i dati di altri studi del passato, la situazione in Europa etc.).
Segnalo l'articolo
Efficacia degli interventi sanitari: efficacy o effectiveness?
Il vaccino antinfluenzale inattivato (in Europa attualmente è approvato solo questo tipo, mentre negli Stati Uniti si usa anche quello con virus "vivi" attenuati che si spruzza nel naso) è considerato safe and effective for pregnant women. We vaccinated more than 60 years against influenza, and data collected on the safety of the vaccine during this long period are many.
Tamma PD, Ault KA, del Rio C, Steinhoff MC, Halsey NA, Omer SB
Division of Pediatric Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD 21287, U.S. In Europe, the flu vaccination for pregnant women is currently recommended in 10 out of 27 countries ( Austria, Belgium, Cyprus, Denmark, Estonia, Ireland, Italy, Portugal, Slovakia and Spain).
Eurosurveillance, Volume 15, Issue 44, 04 November 2010
the note added 9/12/10: This year in Germany as the influenza vaccine is recommended for pregnant women (from the second trimester of pregnancy).
View: Empfehlungen der STIKO am Robert Koch Institut .
4. Women who are at the beginning of the epidemic season in the second and third trimesters of pregnancy
Several studies have highlighted the increased risk of serious complications from influenza, even in the absence of predisposing medical conditions for women in the third trimester of pregnancy or early in the puerperium, flu vaccines are made with killed virus or subunit and not will then, at any stage of pregnancy, the risks associated with the use of vaccines based on live attenuated virus.
For women who are in the second and third trimester of pregnancy during the epidemic season, should be vaccinated against influenza because of the increased risk of serious complications and death related to the disease. Vaccination with inactivated vaccine can be made in any trimester of pregnancy, apparently not associated with adverse effects in the conceptus.
However, it seems appropriate to emphasize that during the first trimester of pregnancy carrying out the vaccination must be subject to thorough evaluation of the risk / benefit by the doctor, since the scientific literature concerning the effects of vaccination performed at this stage of pregnancy is low and not exhaustive.
remember that the influenza vaccine is contraindicated in those who have previously had an anaphylactic reaction to egg protein or other vaccine components, but obviously I'll explain this to the doctor when you go for more information and advice for your case.
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