By Alison Palkhivala
Special to DG News
SAN DIEGO, CA -- October 22, 2002 -- Both family
physicians and obstetricians are not vaccinating their pregnant patients against
flu as often as they should be. False perceptions of contraindications and lack
of reimbursement may play a role in this undervaccination.
The findings were presented here this week in a
poster at the annual meeting of the American Association of Family Physicians (AAFP).
According to the Centers for Disease Control and
Prevention (CDC), pregnant women who will be in their second or third trimester
during flu season should have a flu vaccine, since these patients are at
increased risk of complications from the flu, such as pneumonia. Currently, only
35 to 40 percent of pregnant women are being vaccinated when, in fact, about 75
percent should be vaccinated.
Jennifer L. Chin, MD, from the Santa
Monica-University of California at Los Angeles Family Practice Residency
Program, United States, and colleagues surveyed over 75 family physicians and
obstetricians in an effort to determine their attitudes and practices regarding
the administration of flu vaccines to pregnant women.
Over 90 percent of family physicians reported that
they carry the flu vaccine in their offices, compared with less than 70 percent
of obstetricians. However, a similar proportion of each type of physician (about
75 percent) reported that they administer the vaccine.
Most commonly, the physicians reported that they
believe contraindications to giving the flu vaccine to pregnant women include
being in the first trimester, having a history of preterm labour, having a
history of intrauterine fetal demise and having a history of pregnancy-induced
hypertension.
The only true contraindication for the flu vaccine,
according to the CDC, is allergy to the vaccine or any of its constituents. It
is also recommended that women receive the vaccine only after their 14th week of
pregnancy, as a precautionary measure.
According to the authors, flu vaccines are
underused in pregnant women. They suspect that lack of reimbursement might be a
factor in failure of obstetricians to vaccinate patients, since some insurance
companies consider this preventive medicine, which is only reimbursed when
provided by family physicians.
As a second phase of this study, the investigators
are performing in-office educational sessions about the use of vaccination in
pregnancy and will assess whether these sessions change clinical practice.
ALL INFORMATION, DATA, AND
MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION
PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS
OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR
LEGAL ADVICE. THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND
COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH
YOUR HEALTH CARE PROVIDER.