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H1N1 influenza vaccination during pregnancy

BMJ 2014; 348 doi: (Published 29 May 2014) Cite this as: BMJ 2014;348:g3500
  1. Deshayne B Fell, perinatal epidemiologist1,
  2. Linda Dodds, professor of obstetrics and gynecology and paediatrics2,
  3. Shelly McNeil, associate professor of medicine3,
  4. Noni E MacDonald, professor of pediatrics and microbiology and immunology3
  1. 1Better Outcomes Registry and Network (BORN) Ontario, Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, Canada K1H 8L1
  2. 2Perinatal Epidemiology Research Unit, Departments of Obstetrics and Gynaecology and Pediatrics, Dalhousie University, Halifax, NS, Canada B3K 6R8
  3. 3Canadian Centre for Vaccinology, Dalhousie University, Halifax, NS, Canada B3K 6R8
  1. Correspondence to: D B Fell dfell{at}

H1N1 safety data look reassuring, but we need ongoing surveillance of all influenza vaccines given to pregnant women

Risks to pregnant women from influenza infection have long been recognized.1 The recent 2009-10 H1N1 pandemic was no exception—pregnant women were at higher risk of severe H1N1 influenza illness compared with the general population,2 and those with H1N1 influenza had higher rates of adverse pregnancy outcomes than did uninfected pregnant women.3 Despite limited safety data for use of the monovalent H1N1 vaccines in pregnancy, pregnant women were widely prioritized for H1N1 vaccination programs.4 Fortunately, enhanced surveillance of pregnant women during the pandemic has enabled retrospective evaluation of the safety of monovalent H1N1 vaccine in obstetric populations around the world.

One such evaluation is published in this issue of The BMJ (doi:10.1136/bmj.g3361). Trotta and colleagues report findings from their large retrospective cohort study assessing the relation between an adjuvanted monovalent pandemic H1N1 vaccine administered during pregnancy and adverse maternal and fetal/neonatal outcomes.5 The study was conducted in the Lombardy region of northern Italy and examined a population of 86 171 women with a singleton pregnancy ending in a live birth or stillbirth between 1 October 2009 and 30 September …

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