Dr. Sears: Should Pregnant Women Get the Swine Flu Vaccine?

[BellyBelly]

Monday, October 26, 2009
Should pregnant women get H1N1 vaccine?
By LANDON HALL
THE ORANGE COUNTY REGISTER

Dr. Bob Sears has tried to avoid controversy during the swine flu outbreak. But his recommendation that pregnant women not get the H1N1 vaccine departs from the rest of the medical community.

The federal government and most physicians have spoken in unison on the issue, and they advise pregnant women to receive the injected form of the vaccine because of the virulence of the H1N1 strain and the vulnerability of a pregnant woman's immune system. Two Orange County pregnant women are among 28 who have died nationally since the pandemic began in April. But Sears says the vaccine has never been sufficiently tested for safety on this demographic.

"As a doctor, we swear an oath to 'First, do no harm.' So I have a hard time recommending a treatment that doesn't show it causes no harm," he said. "It's not just the H1N1 vaccine that's not been tested. The regular flu vaccine has not been tested in pregnant women, either, to show that it's safe in babies. That kind of boggles my mind, because the regular flu vaccine has been around for years, and there have been plenty of opportunities for the companies to do some safety testing on them so pregnant women can feel more comfortable about them."

Dr. Felice L. Gersh, an OB/GYN at Women's Medical Group of Irvine who has been practicing for 28 years, echoes the assessment of governmental health agencies, who say the vaccine is safe and are mounting a campaign to urge pregnant women to get the H1N1 and seasonal-flu vaccines. Gersh said Sears and other doctors skeptical of the H1N1 vaccine are "going against the weight of scientific evidence."

"Sometimes in medicine, as in life, you have to go with your best guess using available data," she said. "Everything can't be signed, sealed and guaranteed. This is a judgment call. And all the data is in favor of getting the vaccine."

Christina Chambers, an epidemiologist and associate professor in the Department of Pediatrics at UC San Diego, said Sears' views "don't hold water." She added that history has shown that pregnant women are at greater risk of hospitalization and death during flu pandemics.

"One day you could be feeling fatigued and achy, the next day you could be in a coma," she said.

Because he's part of a nationally trusted brand, Sears' opinions carry great influence. His pediatrician father, Bill, and registered-nurse mother, Martha, wrote a series of books ("The Birth Book," "The Baby Book") that have become indispensible references for expectant and new parents. Sears, his parents and his brother Jim operate out of their seaside practice in Capistrano Beach.

"Dr. Bob," as patients and staffers call him, published his first solo book, "The Vaccine Book: Making the Right Decision for Your Child," in 2007. His inclusion of an "alternate vaccination schedule" brought him criticism from some fellow doctors who see his views as anti-vaccine, an accusation he hotly denies. But in recent postings about H1N1 on the family Web site, AskDrSears.com, his neutrality might have brought more questions than reassurance.

On July 30, he was undecided about the upcoming mass-vaccination effort. But he told readers that "what you can fret about is whether or not the government will make the vaccine mandatory." The first commenter wrote: "Way to fan the hysteria fire there Dr. Bob."

The Centers for Disease Control and Prevention has stated that the H1N1 vaccine is made the same way as the seasonal-flu vaccine, which "millions of Americans have received" over the years. Sears says that's a "completely unscientific statement." He points out, correctly, that no widespread clinical trial of either vaccine has been conducted on pregnant women. The 19-page product insert issued by Sanofi Pasteur, the largest of the five companies that supply the U.S. with H1N1 vaccines, acknowledges that it's "not known whether these vaccines can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity." It adds that the vaccine "should be given to a pregnant woman only if clearly needed."

Chambers, who runs a support center out of UCSD to answer questions about H1N1 (in California, 1-800-532-3749), is gathering information for a future vaccine study. She said symptoms of H1N1 include fever, fatigue, muscle aches, headaches, runny nose, cough and sometimes vomiting and diarrhea. She urges women to get vaccinated, and if they feel symptoms to seek medical attention. Antiviral medications like Tamiflu can be prescribed within 48 hours of the symptoms arising.

"We don't know of any risk from the vaccine, but we do know the risks from getting the virus," Chambers said.

[RockinSAHD]

Just a bit of a safety update as were coming into the flu season and a reminder of the advice above to treat the flu seriously if you are pregnant.


"There has been no indication that inactivated influenza vaccines given during pregnancy harm either the mother or the fetus. This has been repeatedly demonstrated in studies with a combined total of over 10,000 pregnant women immunized with inactivated influenza vaccine, including over 700 women vaccinated during the first trimester"
Expert Review of Respiratory Medicine, June 2010, Vol. 4, No. 3, Pages 321-328 , DOI 10.1586/ers.10.26

"According to the CDC, there have been approximately 700 reported cases of H1N1 in pregnant women since April. Of these, 100 women have required admission to an intensive care unit and 28 have died. In other words, 1 out of every 25 pregnant women who contracted H1N1 died of it. By any standard, that is an appalling death rate."

A safety report from the TGA for the H1N1 vaccine:
Medicines Safety Update No.4; 2010

[Yeddi]

The Skeptical OB... most probably not the best resource. I don't think there would be many people on this forum whose decisions she hasn't insulted in some way through her blog (vaccine debate aside, she is anti-homebirht, anti-VBAC, anti-natural birth and anyone who doesn't agree with her is apparently a "quackivists"). She completely goes against the whole philosophy of this parenting site. Quoting her is not the best way to win friends an influence people...

[BellyBelly]

Isnt Skeptical Ob that Dr Amy woman? The one who carries on about us dangerous doulas, midwives and seriously dangerous people giving birth at home? Meh she would be the last Ob I would reference ANYTHING from. Totally on the war path to medicalise any form of birth and get rid of anyone who opposes. She has personally attacked many iconic birth people in this world who are keeping birth normal.

I dont think you'll get any supporters quoting her stuff, lol. She is the most extreme of Obstetricians and I believe off the register but still on the warpath?! May or may not be true but what she does is very true ... and scary for women around the world.

The H1N1 vaccine also had phenomenal amounts of the vaccine recalled - many millions - as they were not effective, even vitamin D was found to be more effective. That vaccine was a joke in itself. The Vaccine Book is very balanced and not biased.

[RockinSAHD]

Ha, no idea who she is but the stats hold. Guess I'll be changing that reference but you'll have to forgive me for not being up on that kind of thing!
I like quacktavist though, that's nice!

[BellyBelly]

Here's just one of the recalls: YouTube - Nearly 1 million H1N1 vaccines have been recalled - including vax that were given with mercury.

Google h1n1 vaccine recalls.... there were several waves of recalls, not just one, millions were pulled.

[Yeddi]

Isnt Skeptical Ob that Dr Amy woman?

Yep, same one. If she had her way, childbirth of the future would be an automatic booking in for a c-section on your first pre-natal visit.

[RockinSAHD]

Yep, same one. If she had her way, childbirth of the future would be an automatic booking in for a c-section on your first pre-natal visit.

And that's not a character assassination?

[BellyBelly]

She is one piece of work SAHD. Big time. She is absolutely crazy nuts fixated on it.

[Yeddi]

And that's not a character assassination?

It's not character assassination to practically quote someone is it?

Lets just say quoting her anywhere on this site would be like me quoting Wakefield as my only source in a vaccination debate...

[RockinSAHD]

Here's just one of the recalls: YouTube - Nearly 1 million H1N1 vaccines have been recalled - including vax that were given with mercury.
Google h1n1 vaccine recalls.... there were several waves of recalls, not just one, millions were pulled.

I did, here's the response from the CDC, which seems consistent with the youtube news report...
CDC H1N1 Flu | Non-Safety-Related Voluntary Recall of Sanofi Pasteur Pediatric Vaccine (December 2009)

Apparently the vaccines passed testing for potency when they left the factory but were degrading too quickly, so the potency when they were supposed to be given may have been low. If they hadn't chosen to recall (it was voluntary) then people given the vaccinations would've had a slightly lower chance of getting the immunity.

True front page reporting!

(PS This didn't affect Australian vaccines, we have a different manufacturer)

It's not character assassination to practically quote someone is it?

I would've thought so, but your the woman with the dictionary! (On a side note the Dr Amy woman does look like a bit of a nutcase!)

[JellyBean]

Yep, same one. If she had her way, childbirth of the future would be an automatic booking in for a c-section on your first pre-natal visit.

Oh the beloved Dr Amy Tuteur. If she could somehow genetically modify the human genome to be void of a vagina she would! It seriously wouldn't surprise me if she advocated growing the baby in an artificial womb before having it delivered to your door.

Lol. My DH joked that perhaps she is actually a robot. He's all for empowering vaginas you see.

Just slightly off topic here.....

[RockinSAHD]

The H1N1 vaccine also had phenomenal amounts of the vaccine recalled - many millions - as they were not effective, even vitamin D was found to be more effective. That vaccine was a joke in itself. The Vaccine Book is very balanced and not biased.

The '09 flu vax had a 50% chance of giving immunity (seroconversion rate) and your right Kelly, thats an awful stat for a vaccine but still that seems pretty good to me considering and I would still encourage my DW to get the shot. Actually she was pregnant in winter 09 and we had a scare, I'm pretty sure she did have it.

If you can find me a Vit D pill that is that effective in an adult with a good diet I want to buy them!! I assume that your using Dr Mayer Einsteins magic vitamins!

[trishalishous]

Personally we were advised to wait until 34 weeks before I had the flu/h1n1 shot (if there were any issues DD was strong enough to be delivered early)
I had H1N1 and it wasnt TOO bad (I was also still recovering when I fell pregnant) but then I had dengue fever, which was bad!

[brogeybear]

There is no way that I will be getting the flu vax, particularly while pregnant. The vaccine is not recommended or proven safe in children under two, so why would I subject my rapidly growing and developing foetus to it? Not to mention that the flu vaccine is always at least one year behind so you are not protected against the new strains of the virus which have mutated over the last 12 months.

[BellyBelly]

I just work out in the sunshine with the macbook on my lap and cuppa in the other hand for my Vit D fix