Quick poll - Pg ladies, how pg are you and will you be having the swine flu jab?

[laurawantsababy]

I am 25 weeks pg with dc2 and very confused.

After another death but with conflicting advice about the jab chosen for the UK what are we to do??

I would love you here everyones choice and thoughts on it to help me out.

Thanks

Hi ladies,

Wanted to just read the thread without posting this but I found out I was pregnant last week with DC2. We were not going to tell anybody until after 3 months as our DD is not even 6 months old yet.

I am totally confused with all of this. It hadn't really crossed my mind until Monday when I was at the docs and the receptionist told me that my doctor advised me to come in this Wednesday afternoon for the swine flu jab. I took the appt but told her that if I change my mind I will call to let them know.

I've spent the past day researching on the internet and for every 5 doctors/health professionals that are saying pregnant women should take the jab, there are 5 other doctors/health professionals saying it should not be taken.

I called the docs today to find out what vaccine it is, they said they are using Pandemrix. I've noticed a lot of people saying they will not take this and I'm worried now. Not to mention Im still very early on in my first trimester (5 and a half weeks atm), but when I called the docs today they said it can be taken in any trimester.

Sorry this is a long post but Im am soooooo worried about this. We had 3 miscarriages before we had DD so I was already very nervous about this pregnancy.

The appt is tomorrow and I just dont know what to do.

Mistletoekisses - agree with you that my consultant is actually being a bit of a nightmare as she is essentially putting me in a bit of an impossible position which isn't particularly helpful, and all the onus is now on me to make the "hobson's choice" - it's almost like saying, "there's a high probability of you getting seriously ill if you don't have it but if you do have it then you could be damaging your baby". So either choice I make, SHE is covered, but I have to live with the stress of worrying about the horrid consequences of either choice. I had hoped she might reassure me in one way or another (or at least weight the risks of either choice) and put her money where her mouth is, but perhaps I am not being adult about this and I shouldn't expect her to tell me what to do. My husband is also quite annoyed as now he has to deal with a stress case wife (who is now busily spraying everything with antiseptic and cancelling our social calender for the next couple of months!!!) OH - and her stats for Brazil of 1000 pregnant women dying is NOT reflected on the NHS website, so I am not even sure if her info is correct or where it has come from. Sorry - getting worked up again over this whole mess.

Blimey its tricky, isn't it . I'm 28 weeks and trying to decide what to do for the best, but I'm starting to wonder whether we're getting facts or opinions from everyone. I had been thinking not, now I'm thinking probably, but...

On the subject of which, lumpasmelly - I'm so cross on your behalf re. your consultant. To me, either she should follow the official advice and recommend the jab whatever your stage of pregnancy, or she should choose to give you a different opinion. She seems to be trying to do both, which doesn't strike me as putting the best interests of her client first. Please can you ask her for the references she is using to recommend you go against official guidelines by holding off on having the vaccine (or ring her up and say you're struggling to find the source of her numbers and can she provide them so you can do some digging and try to put your mind at rest)? It would make her advice a lot easier to weight if we knew whether it was her gut feel or the opinion of her senior immunologist friend who also happends to be an obstetrician...

In general, does anyone know what the seasonal flu vaccine(s?) are called? I've read the entire thread and may have missed it, but it may help me to decide - my current thinking is that for all the SF vaccine isn't currently recommended for all pregnant women (although I did see a suggestion that that was about to change), it has been given to quite a lot of them if they have additional risk factors. As such, many elements of the seasonal flu vaccine have been "tested" on pregnant women albeit through usage rather than in a clinical trial. If the only difference between the SF vaccine and the seasonal flu vaccine is the antigen then I'd feel a lot happier sidelining all of the concerns that have been raised about the other factors (which I'd probably spell wrong so won't ry ). I'm getting a bit confused as some posters seem to think Celvapan is the seasonal flu vaccine variant, but then you're advised not to have the seasonal jab if you're alergic to egg - and Pandemrix is the vaccine grown in egg...

Thanks for any info

(although knowing my luck I'll make my mind up to have it and then find out my GP either won't be getting theirs for the next 6 months or they used the last shot last week and forgot to send me an invite... Cynical? Me? )

Actually lumpasmelly your consultant got her numbers mixed up about the Brazilians deaths of SF...1368 people have died of SF in Brazil, 1414 pregnant women have contracted SF and of those 135 have died. I got these numbers from this article in portuguese from a brazilian news site quoting the Brazilian Health Ministry for the dates between the 25th April and 10th October. I hope this puts things back into a more realistic and less morbid perspective.
I am still reticent regarding the vaccine and will probably drag my feet up to the last minute but I do not like the panic spread by erroneous death numbers and your consultant should check her sources twice before passing this kind of information to her patients.

Lumpasmelly - as you say, your consultant has totally covered herself from getting any comeback but has not helped you one iota. I can understand why your DH is irritated and why you are so upset. The first thing I would say is try to relax. We are all in the same boat and as much as the medical professionals can advise us; it is a very personal decision. And one of weighing up risks vs benefits.

The truth is that no one absolutely knows what the impact of the vaccine will be on our unborn children. We can surmise, but we dont know. And therein lies the risk.
But we also know that swine flu is causing more complications to pregnant women - some resulting in death. And there is another risk.

It is basically one of those damned if you do, damned if you dont decisions.

Have you and your DH sat down and discussed this? What does he think? Maybe show him this thread and make your decision. How much more helpful is your consultant going to be next week?

Interestingly the NHS immunisation site suggests that where possible pg women should be given the thiomersal-free seasonal flu jab
here

Pregnant women have an increased risk of complications from any type of flu but we still only give seasonal flu vaccine to those with additional risk factors

Mistletoekisses,

"It is basically one of those damned if you do, damned if you don't decisions."

sums up the whole discussion.... those who end up having the jab AND those who don't and who get the flu, even if mildly, and then go on to have babies who have any health issues are probably going to blame themselves (even if there is no proven link) and regret whichever decision they made.

This is my first baby and I have a feeling that there are going to be a lot more decisions like this....

Lucy - you have no idea.

bfeeding or ffeeding
rooming in or not rooming in
dummy or no dummy
early weaning or waiting the recommended 6 months
mmr or not mmr
WOHM or SAHM
nursery or nanny

It absolutely carries on...the list could be much longer...

texasghouldem hmmm it might have changed without me spotting it but I think the advice is to be vaccinated in second and third trimesters only, unless your practitioner advises otherwise, which is usually only if the pregnant woman belongs to other risk groups as well. With other complicating health factors, it may be worth the calculated risk of having the vaccine in the first 12 weeks of pregnancy. Otherwise most medic don't like taking any 'unecessary' risks in the first trimester.

In general there is not so much risk from SF to the mother in the first trimester (lung capacity reduces gradually to its lowest in the last weeks before birth, when the body is also working its hardest pumping more blood etc), even though high fever is never good for a fetus and has been linked to miscarriage risk in the first trimester.

If I were you I would do some more reading on the NHS pages and the WHO to check about first trimester vaccination and consult your GP about your medical history.

Tangle don't know what the seasonal flu vaccines are called. Cevlapan is a pandemic vaccine against swine flu, developed by Baxter in competition with Pandemrix which does the same thing, developed by Glaxo SmithKline. Cevlapan is not based on eggs, it does not contain mercury, which is used in Pandemrix to keep the vaccine sterile, and it does not contain an adjuvant. The adjuvant is a natural (shark) oil and vitamin E ingredient added to Pandemrix to boost the body's immune response to the vaccine's antigens, it means that less of the virus is needed to get the same immune protection than if the adjuvant is not used. According to the mumsnet chat with Professor David Salisbury, the adjuvant also increases the chance of the body being protected against a mutated version of the virus if that should ever crop up. The adjuvant has been linked with a lot of controversy, somewhat unfairly based on my reading as there is no evidence really that is has any harmful side effects. You can find lots of info about adjuvants on the WHO website and general google searches will no doubt give you the scare side of the story. Anyway understandably some pregnant women prefer the idea of a vaccine without it, to be on the safe side.

The WHO recommends pregnant women in 2nd and 3rd trimester should be vaccinated with whichever vaccine is available to them, although they initially said they prefer the non-adjuvant vaccine purely on the basis of the lack of data of adjuvant vaccines in pregnant women.

dd is 15wks pg not been offerd the jab and not sure to have it anyway

The French Ministre de la Sante (Health Minister) recommends a non-adjuvanted vaccine for pregnant women, and adds that pregnant women should only be vaccinated once in their second trimester or further along.

sorry the article is in french

Arrghhh!

thanks midnightsun - have you had the jab? Sorry if you have already said this before - I tried to read as much as I could of the thread but was started to get all confused!

I read in a couple of websites that health professionals were advising to get it asap even if first trimester but then again like you say there are those that are saying no in the first trimester! When I phoned the docs today they said yes I should get it. Will check the NHS website and see what it says......

alyonor, those stats for Brazil are still pretty terrifying. 135 / 1414, that's nearly 10% death rate which is worse than any other I've read.

texasghouldem I may have been wrong. It looks like the NHS swine flu information leaflet says women at ANY stage of pregnancy are in the high risk group.

www.nhs.uk/news/2009/04April/Documents/SF-vaccination-leaflet.pdf

Where I live (Norway) they are only vaccinating pregnant women in the second and third trimesters.

The WHO information indicates that it is pregnant women in those trimesters who are at greater risk of hospitalisation.

This BBC reporter's blog (somebody linked to it a while ago, it's updated all the time) is factual with links to a lot of good info and he pulls out some relevant highlights for pregnant women.

www.bbc.co.uk/blogs/thereporters/ferguswalsh/

oh and yes, I had the jab (Pandemrix) a week ago.

Someone was worrying about their baby's hearing being affected by the vaccine (I don't think this is based on anything concrete) and I meant to say this in an earlier post. I was 24 weeks when I had the vaccine and I have noticed my baby kicking in response to the car radio (I have it quite loud!) and the chirpy voice of my 3 year old son first thing in the morning when we wake up.

So I am not worried about that at all. Anecdotal reassurance to an anecdotal worry there, I think. Not much clinical evidence either way.

Pregnant women are routinely vaccinated against other illnesses where required provided that the vaccine is not live (and in Pandemrix it is not, the virus is killed/inactivated). So this is not the first time pregnant women have had vaccines. Many pregnant women get the seasonal flu vaccine as a standard policy, for example, although it is not recommended in every country.

Tomatofarcie - the article you link to is dated 16 October. Do you know if they are still advocating the non adjuvanted vaccine in France? Things are changing so quickly all the time - a few weeks ago this was the advice from the WHO before they changed their minds. Also, the article does say that this advice is subject to change if the number of cases and their severity increases - surely this is the case now?

Very odd that only one dose of Celvapan is being offered in Ireland. My mil had Pandemrix on Saturday and is due to have another dose in 3 weeks as she has an auto-immune disease.

Have meant to say this before but many thanks to laurawantsababy for starting the thread and to midnightsun among others for such useful comments.

ReneRusso indeed the numbers are frightening but the SF cases in Brazil are over 30'000 (according to flucount.org) and the total death has reached 2100, so there is still a considerable difference between 1000 pregnant women dying of it and 135... what is more frightening is that you can get such mixed up information coming from a consultant which you would assume would be responsible enough to check and verify the information she is passing to her patients. If she does such a mistake with the death numbers how can we trust her other comments about birth defects?
Regarding the brazilian death toll, it seems to be the country to have the most death of SF... due to the population density? I have no idea, I am no specialist on pandemics.

They have fairly recently updated the recommendation for Pandemrix, based on new test data which shows that one dose is enough for adults and children with a healthy/normal immune system to attain adequate antibody levels to protect against the virus as much as the body can.

Very young children (under 3s I think) and patients with compromised immune systems may still need two doses 21 days apart to reach the same immunity level. Since they won't test everyone's antibody levels to see if they need two doses a lot of clinics will just administer it as standard. Also because the recommendations earlier were that two doses were needed, some practices may still be going by that.

Could be the same for Celvapan, I haven't been following that one so closely as it is not available where I live.

Should have specified that kids (under 10) will, when appropriate, receive a half adult dose and then if needed another one 3 weeks later. They update the recommendations continuously based on ongoing trials and feedback from use in the general population.

Midnightsun - my GP have updated their practice. When I had my first Pandremix jab, I was told to come back in 3 weeks for the second jab. However then picked up a message saying that the second appointment wasnt needed. Aside from being pregnant, I have no other underlying issues that require my having a second dose.

Lumpasmelly - am hoping that you have managed to wade through the info and come to some sort of decision for the moment.

Mistletoekisses - Sensible DH has taken it upon himself to quell my hysteria and going to talk to the consultant today. He is better than I am at separating the fact from the speculation, and I feel confident that once he has had this conversation that we can sit down and talk about it rationally (think I am a bit too hysterical at the moment!!!).......on a related note, some of my friends at my son's school have received letters from a private pediatrician that many of them use offering the Swine Flu jab to children, and another friend was offered it this Easter when she had to take her son to the doctor in Florida. Of course vaccinating children is a whole other discussion but for those women who are still unhappy about the vaccine while pregnant, perhaps vaccinating the family might be another line of defense? I may look into this as a short term option, though would need to do some research.

Lumpasmelly - am glad your DH has taken that route. I think my DH would have done the same in similar circumstances.

I havent considered the jab for DS yet, havent even looked into implications of him catching s.f. He has no underlying health concerns...hence is not on GP's priority list. But a private GP would give it to him. So will look into it. Let me know what you find.

And let us know how your DH gets on.

lumpasmelly yes vaccinating everyone else in the household is an official strategy for people who can't be vaccinated for one reason or another so that's a pretty sensible option. Here, the next people on the priority list are parents of babies under 6 months and the families of women in the first trimester of pregnancy. WHO recommends vaccinating as many under 10s as possible as they have higher than average SF hospitalisation rates.

Incidentally the media here reported on a heavily pregnant woman who had swine flu without knowing it. She had been to the doctor a few times with a cough that wouldn't shift and a swab test done "just in case" came back as positive for swine flu. She had no other symptoms. So that's good for the perspective I suppose. The illness was of no danger to her or her baby but she was a bit concerned about all the poeple she might have gone round unwittingly infecting, as she said sh'd have been a lot more careful with social visits and cough hygiene if she'd known she was carrying swine flu germs. Interesting case, anyway. Link here although I don't suppose many people on this board read Norwegian, sorry.
www.vg.no/helse/svineinfluensa/artikkel.php?artid=582554

The WHO have expressed concern about Norway's high hospitalisation and death rate compared to other countries in Europe. With a population of 4.5 million (about the same as Ireland), there have been 15 deaths I think they correspond more or less with the UK rates though. Explains why our respective medias are giving it a lot of space.

Obviously the media are having a "oh it's not that bad everyone calm down" day today anyway. Tomorrow they will probably be telling us we're going to die, again.

Just spoke to DH who has spoken to consultant. After talking to her he does not want me to have the vaccine until I am a bit further along.....still need to determine what that cut off point is but further into the 2nd trimester, if not into the third. In the meantime, he wants to get himself and our two children (aged 2 and 5) vaccinated so I am currently looking into having that done privately....and then it's probably a case of minimising contact with other people for me until the time comes to vaccinate myself. So in short, I WILL have the vaccine, but just not yet and will have to ride out the pandemic and hope I don't get it in the meantime.....obviously if pregnant women start dying in large numbers over the next couple of weeks then we will revise this view, but for the time being it is the best compromise we can think of......now i need to enter the minefield of "is it safe to vaccinate a 2 year old" but reckon that if I'm having the vaccine in the third trimester and trust it then, it should hopefully be an easy decision to make.

I'm having the jab this week(I'm nearly 28 weeks). I don't feel completely confident, but I really haven't seen any concrete evidence which suggests my baby might be harmed. And I have seen evidence that swine flu is dangerous for pregnant women and their babies. Being practically in the 3rd trimester has helped me make my decision. Possibly if I were not so far on I would be more worried. But I'd still have it.

Out of interest, if you are one of the women choosing not to have the jab, would you also avoid taking Relenza?

TBH I would be more concerned about what the NHS say about Relenza and unborn babies than their take on the safety of the vaccine. The NHS website says Relenza is "unlikely" to harm your baby. That's far less equivocal than the assurances given over the vacccine. That "unlikely" would worry me more, and I certainly wouldn't want to forgo the vaccine and then find myself taking Relenza.

I've also read that the Anti D injection (which I had early in the pg after some bleeding because I'm rhesus negative) usually contains thimoresal. It never occurred to me not to have the injection.