Swine flu vaccine: Pregnant women to the head of the line

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Pregnant women are likely to be among the first groups recommended to receive the vaccine for the new H1N1 influenza, commonly known as swine flu, because of their unusually high risk of dying from an infection. Of the 266 U.S. swine-flu-related deaths for which the Centers for Disease Control and Prevention has detailed information, 15 were pregnant women, the Associated Press reported this morning. That amounts to 6% of the deaths, although pregnant women account for only 1% of the population. Most of the women were healthy before they contracted the virus.

The CDC’s advisory committee on vaccination will meet in Atlanta on Wednesday to set priorities for who should receive the new vaccine, which may begin to be available by October. The group is expected to follow a recommendation from the World Health Organization that healthcare workers, who are on the front lines of caring for infected patients, be the first to receive the vaccine. It now seems likely that pregnant women will be next.

Pregnant women have long been known to be at increased risk for adverse effects from seasonal influenza, and health authorities recommend every year that all pregnant women be vaccinated. Even so, only about an estimated 15% receive the shots. The women are thought to be at risk of developing pneumonia -- and dying -- because of changes to their lungs and immune system that are a normal part of pregnancy, and many physicians fear that the risk is even higher with H1N1. In fact, British and Swiss health authorities have notoriously argued that women should pospone getting pregnant until after the pandemic has passed.

The vaccine protects not only the mother but also her baby. A study conducted in Bangladesh and reported in the New England Journal of Medicine last year found that vaccination for seasonal flu reduced flu in infants by 63%.

-- Thomas H. Maugh II