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Less than one in five pregnant women are having the A/H1N1 vaccine

Shiloh

Editor, Senior Moderator
Source: http://www.express.co.uk/posts/view...e-than-half-a-million-pregnant-women-at-risk-


SWINE FLU: MORE THAN HALF A MILLION PREGNANT WOMEN AT RISK

Friday December 25,2009
By Nicola McCafferty EXCLUSIVE for Express.co.uk


MORE than half a million pregnant women are at serious risk of contracting swine flu after refusing to be vaccinated.

Around 550,00 pregnant women in the UK have been offered the swine flu vaccine, but only 101,000 have accepted it amid fears it is unsafe.

This means less than one in five pregnant women are protected, despite being the most at-risk group of contracting the potentially-deadly H1N1 strain.

The Department of Health (DoH) advises all soon-to-be mothers to have Pandemrix or Celvapan injections from their GPs, as research shows they are more at risk of developing serious complications - including miscarriage and premature labour.

In addition, figures from the World Health Organisation show up to 10 per cent of all hospitalised patients with swine flu are women who are more than three-months pregnant.

Yet the new vaccine - which has been trialled on just 5,000 people - has divided patients and their GPs, many who feel it poses a risk to the development of the baby in the early stages of pregnancy.

Daily Express columnist and GP Dr Rosemary Leonard has refused to adopt the DoH's stance to inoculate pregnant women in their first trimester - insisting it is less risky to have the vaccination later on when the baby is fully-formed.

"Administering the swine flu vaccine in the early stages means there is an increased risk of respiratory failure later on in pregnancy," she warned.

"We try to avoid giving drugs at all costs to pregnant women. Any vaccines are a risk and your immune system alters a lot during pregnancy, so why go giving them when there is no rush?"

She went on: "As far as we are concerned, H1N1 has gone away. We are just seeing people with lots of coughs and colds.

"We're not pushing inoculations. In fact, we're giving women the choice."

Heavily-pregnant Suzanne Jamal told Express.co.uk she declined having the injection because she felt the risks to herself and her baby were too great.

She said: "I decided not to have it and the reason was because when you're pregnant, you're not meant to take any medication whatsoever. The only thing you can have is paracetamol.

"So it seemed odd to me that throughout my pregnancy I couldn't take anything at all, to then actually take a vaccine.

"They tell you the risks, which can include your blood pressure going really high.

"It is quite frightening, but [ultimately] it's up to you. I feel I have a good immune system - I can't remember the last time I had a cold - so I decided not to."

She added: "My husband wanted me to have it, but I feel that as I had stopped working and wasn't going out a lot and being in close contact with people that taking the vaccine just didn't sit well.

"I just made a calculated guess that I might not get it."

The medical profession has reacted angrily to the high levels of resistance amongst pregnant women to the swine flu jab, claiming it is vital to have it sooner rather than later.

The Department of Health told us: "Vaccination against swine flu is the best defence, both now and in the coming months.

"Having the swine flu vaccine now could help you avoid catching swine flu and protect your baby."

Last week's figures on the swine flu pandemic show the number of cases is dramatically falling, with an estimated 9,000 in England currently - down from 11,000 the week before.

However the UK death toll for cases linked to the virus now stands at 298, up from 283 in the previous week.

Dr Leonard is advising that while pregnant women remain in the difficult position over whether to have the jab, being inoculated later on in their pregnancy is a safer option.

"We are still saying it [the vaccine] is worth having. But we won't give it immediately," she says.

"We think it is safe to withhold the vaccines until the baby is formed, so two-to-three months in."
 
Re: Less than one in five pregnant women are having the A/H1N1 vaccine

"They tell you the risks, which can include your blood pressure going really high.

Pre-eclampsia, or high blood pressure during pregnancy, is the result of excessive maternal systemic inflammation, which adjuvants will aggravate. See this review Redman 2003 Pre-eclampsia, the placenta and the maternal systemic inflammatory response--a review.

From the abstract:

The evidence that maternal syndrome of pre-eclampsia is caused by a maternal systemic inflammatory response (MSIR) is reviewed. The polymorphic nature of the inflammatory network explains the diversity of the varied signs of this condition. A key observation is that an MSIR is also a feature of normal third trimester pregnancy, but less severe than in pre-eclampsia. Hence pre-eclampsia is simply the extreme end of a continuum common to all pregnancies, with multiple contributing factors. Evidence is presented that apoptotic or necrotic debris shed from the syncytial surface of the placenta constitutes the inflammatory stimulus in all pregnancies. This model explains many features of pre-eclampsia including its occurrence with either larger placentae or small oxidatively stressed placentae. The clinical implications are that in terms of diagnosis or prediction there can never be a clear distinction between normal and abnormal. No test, predictive or diagnostic, can be expected to distinguish absolutely between different degrees of a problem that is common to all pregnancies. The possibility that the MSIR associated with third trimester pregnancy is nothing more than the maternal price for sustaining gestation is considered.

The fact that pre-eclampsia is a continuum from normal pregnancy means that the risk exists in every pregnancy. Causation is multi-factorial, but excessive maternal immune stimulation at the third trimester is certainly a concern. Which means that vaccinating later (as expressed towards the end of that article in the Daily Express) only avoids the potential for fetal malformations, but not the considerable risks associated with pre-eclampsia (15-20% of maternal mortality in developed countries (Sibai 2005 Pre-eclampsia), plus risks for fetal distress, the need for preterm induction of labor, and increased risk of cardiovascular complications in later life, etc.
 
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