Intended for healthcare professionals

Editorials

Flu vaccination in pregnancy

BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l4454 (Published 10 July 2019) Cite this as: BMJ 2019;366:l4454

Linked research

Health outcomes of young children born to mothers who received 2009 pandemic H1N1 influenza vaccination during pregnancy

Re: Flu vaccination in pregnancy

FIRST TRIMESTER FLU SHOTS: NOT A GOOD IDEA

The Haberg/Wilcox editorial about flu vaccination in pregnancy (BMJ 10 July 2019) and the linked article by Walsh, et al (BMJ 10 July 2019) both do not mention the 20% increase in the subsequent risk of autism spectrum disorder/ASD among the offspring of women in a large cohort study who got flu shots during the first trimester. (Zerbo, et al. JAMA Pediatr 2017;171e163602) The adjusted hazard ratio was 1.20 [CI 1.04-1.39], P=0.01. This amounts to 4 additional ASD cases for every 1000 women vaccinated.

The authors concluded, however, that the association was insignificant (P=0.1) after statistical correction for multiple comparisons. However, subsequent letters to the journal asserted that such statistical corrections were unwarranted. They presented data showing that a vaccine/autism link was biologically plausible and asserted that we should refrain from flu shots, at least in the first trimester of pregnancy. (Hooker, Dozelli, et al. JAMA Pediatr 2017;171:600)

ALLAN S. CUNNINGHAM 17 July 2019

Competing interests: No competing interests

17 July 2019
Allan S. Cunningham
Retired pediatrician
Cooperstown NY 13326, USA <crabarbicus62@gmail.com>