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