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| |  Maternal Influenza Vaccination May Be Associated With Flu Protection in Infants CHICAGO -- October 4, 2010 -- Babies whose mothers received influenza vaccines while pregnant appear less likely to be infected with influenza or hospitalised for respiratory illnesses in their first 6 months of life, according to a study published early online and appearing in the February 2011 print issue of the Archives of Pediatrics & Adolescent Medicine. “Influenza virus infection in infants is generally more frequent among those aged 6 to 12 months than in the first 6 months of life, potentially owing to the protection conferred by maternal influenza antibodies acquired transplacentally or through breastfeeding,” the authors wrote. “However, during severe influenza seasons, morbidity and mortality rates among infants younger than 6 months have been reported to exceed those of older infants.” Angelia A. Eick, PhD, then with the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, and now with the Armed Forces Health Surveillance Center, Silver Spring, Maryland, and colleagues conducted a non-randomised observational cohort study on Navajo and White Mountain Apache Indian reservations, where children have a higher rate of severe respiratory infection than the general population. A group of 1,169 women who delivered babies during 1 of 3 influenza seasons completed questionnaires about demographics, vaccination status of all family members, and flu risk factors. A total of 1,160 mother-infant pairs then gave blood samples that were assessed for influenza antibody presence. Mothers completed a second questionnaire at the end of the influenza season and surveillance was conducted throughout to track new influenza-like illnesses. During the influenza season following their birth, 193 (17%) of infants were hospitalised for influenza-like illness, 412 (36%) had only an outpatient visit for a respiratory cause and 555 (48%) had no influenza- or influenza-like episodes. Infants whose mothers were vaccinated had a 41% lower risk of laboratory-confirmed influenza virus infection and a 39% reduced risk of hospitalisation from influenza-like illness. In addition, those with blood samples available had higher levels of influenza antibodies at birth and at 2 to 3 months than babies born to unvaccinated women. “Although influenza vaccination is recommended for pregnant women to reduce their risk of influenza complications, these findings provide support for the added benefit of protecting infants from influenza virus infection up to 6 months, the period when infants are not eligible for influenza vaccination but are at highest risk of severe influenza illness,” the authors concluded. “These findings are particularly relevant with the emergence of the 2009 influenza A(H1N1) virus, which had a substantial impact on pregnant women and high hospitalisation rates among young infants.” In an accompanying editorial, Justin R. Ortiz, MD, and Kathleen M. Neuzil, MD, PATH and the University of Washington, Seattle, Washington, wrote: “The burden of influenza among pregnant women, the excellent safety profile of the vaccine and the reliable immunogenicity of trivalent inactivated influenza vaccine in this group support a recommendation that all pregnant women receive influenza vaccine to decrease complications of influenza disease during their pregnancies. While the burden of influenza is not as well characterised in many tropical and developing countries, available evidence, including evidence from the recent H1N1 pandemic, supports that pregnant women are at high risk for influenza-related morbidity.” “The additional benefits of maternal influenza vaccination to the newborn, as demonstrated in the Bangladesh and White Mountain and Apache Navajo communities, should catalyse efforts to improve vaccination rates in countries with existing maternal immunization recommendations,” they concluded. “Likewise, these data should encourage the adoption of vaccination guidelines in countries without such recommendations. Maternal influenza vaccination targets 2 high-risk groups with 1 vaccine dose -- we can’t afford not to act.”
SOURCE: Archives of Pediatrics & Adolescent Medicine
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