The flu jab in pregnancy: why it matters and when to have it

As the weather turns cold, polyclinics begin their flu vaccination season, and many pregnant women hesitate: is it allowed, could it harm the baby, would it be better to wait until after the birth? Here we explain why doctors around the world, including in Uzbekistan, treat mums-to-be as a priority group for vaccination, how safe the jab is and how to get it.

Why flu is more serious in pregnancy

Flu is not just a bad cold. During pregnancy your immune system, heart and lungs work differently: your immunity adjusts so that it does not reject the baby, your heart pumps more blood, and the growing womb pushes up against your diaphragm. As a result, flu is more likely to be severe in pregnant women and more likely to lead to pneumonia, particularly in the second and third trimesters.

A high fever and serious illness in the mother also raise the risk of premature birth and other pregnancy complications. That is why the World Health Organization and Uzbekistan’s Ministry of Health list pregnant women as a priority group for the seasonal flu vaccine.

Is the vaccine safe?

Pregnant women are given an inactivated flu vaccine. It contains no live virus, so it cannot give you flu. These vaccines have been used in pregnancy for many years, their safety has been studied in very large numbers of women, and the international consensus is clear: the inactivated vaccine is safe in any trimester, for both mother and baby. It does not increase the risk of miscarriage or birth defects.

The live nasal spray vaccine is not suitable in pregnancy. So when you go for your jab, check with the nurse that you are receiving the inactivated injectable vaccine.

Afterwards you may have the usual mild reactions: a sore, red arm where the needle went in, slight tiredness or a mild temperature for a day or two. These pass on their own. Serious allergic reactions are extremely rare, which is why you are usually asked to wait at the polyclinic for 15–30 minutes after the injection.

How the jab protects your baby

This is perhaps the most underrated benefit of vaccination. After the jab your body produces antibodies, and some of them cross the placenta to your baby. Babies under six months are too young to have their own flu vaccine, yet they become more seriously ill than older children. Your antibodies protect your baby during exactly these first, most vulnerable months — and breastfeeding helps to support that protection.

When and where to get vaccinated

• The best time is autumn, before the flu season peaks — October to November. But it is not too late in winter, as long as flu is still circulating.
• Your stage of pregnancy does not matter: you can have the jab in any trimester. There is no need to wait for the second trimester.
• Where: ask your obstetrician-gynaecologist or your GP at the family polyclinic. During the vaccination season pregnant women are usually vaccinated at their local polyclinic.
• Protection builds up about two weeks after the injection.
• You need the vaccine every year: flu viruses change, and the vaccine is updated for each season.

If you have recently been ill, have a temperature now, or had a severe allergic reaction to a previous vaccine, tell the doctor before your jab so they can decide when and how best to vaccinate you. An egg allergy does not usually rule out the vaccine, but mention it too.

Other ways to avoid flu

The vaccine is your main protection, but not the only one. Wash your hands, especially after public transport and shopping; air your rooms; avoid crowded places at the height of the season where possible; and keep your distance from people who are coughing and sneezing. Ask family members with cold symptoms to wear a mask at home. It is also worth relatives getting vaccinated — together you create a ‘cocoon’ of protection around you and your baby.

When to see a doctor

If you develop a temperature, aching muscles, a cough or chills during pregnancy, see a doctor the same day rather than waiting for it to pass. In pregnancy, flu treatment works best when started within the first 48 hours. Take antiviral and fever-reducing medicines only as prescribed by your doctor.

Call an ambulance on 103 if:

• you are struggling to breathe, short of breath at rest or have chest pain;
• your temperature stays high and will not come down;
• you become confused, very drowsy or have a fit;
• your lips turn blue;
• your baby is moving much less than usual or has stopped moving;
• you have bleeding, leaking fluid or contraction-like pains.

The takeaway

Flu is more serious during pregnancy, and the vaccine is a simple, safe way to protect yourself. The inactivated jab can be given in any trimester, and it protects not only you but also your baby in the first months of life. Ask about it at your next polyclinic appointment — it is best to have it now, at the start of the season.