Not too late: Flu shots can still protect babies and moms

The recent news that a four-year-old Iowa girl who did not receive the flu shot this season has lost her eyesight — and it may be permanent — as the result of the flu is a reminder of the dangers of the flu this season. 

One child in Chicago has already died this year. Late last year, a five-year-old in Texas died of the flu; he had not had a flu shot.

The Centers for Disease Control report at least 13 million cases of the flu in the U.S. so far this year, 120,000 hospitalizations, and 6,600 deaths, including 39 children.

While it is months into flu season, It is not too late for anyone, especially small children and pregnant women to get the flu shot.

As a former neonatal clinical nurse specialist and a current pediatric clinical pharmacist, we have cared for babies who have been separated from their mothers who are sick with the flu. In many cases, infants are taken to the neonatal intensive care unit, so that contact with the mother can be avoided until symptoms are clear, including breastfeeding. 

Mothers who can do so can pump their milk and send it to the nursery for feeding. Flu exposure can cause serious consequences for newborns, especially those born premature, including breathing problems that require the use of a mechanical ventilator. 

Respiratory viral illness can quickly become dangerous in children. This includes young children, but also young teens who arrive in the emergency department with some difficulty breathing and within hours needs to go to the pediatric intensive care unit for further care including IVs, sedating medications, antibiotics and breathing treatments.

If the patient is not up to date on their vaccines, there is little the medical team can do except try to control the symptoms. In the hospital setting, we see flu-related sicknesses requiring an inpatient admission last over two weeks. 

Also, in clinical practice, pediatric patients who do not receive the appropriate immunization schedule do not have the proper immune response to fight the flu. Babies and children who are six months to eight years old when first immunized need two flu shot doses about one month apart to adequately protect them from the flu. 

In one case, a 5-year-old was admitted with respiratory distress from the flu. He was believed to be “up to date” with immunizations by his parents but had never received the second “booster” vaccine. It is impossible to say if he still would have developed a viral illness anyway, but without this second dose, he was unprotected and at risk. His parents were educated and were able to use this insight in their younger children.

Illinois is one of six states reporting moderate flu activity; however, 19 other states are reporting high activity in California, New York, and Texas. States with the highest flu vaccination rates include West Virginia, Washington, and Minnesota. However, states like Indiana, Texas, Louisiana and Tennessee are some of the lowest ranking states for receiving flu vaccinations 

According to the CDC, receiving the influenza injection can reduce a person’s risk of getting sick 40 to 60 percent. But getting the shot is more about preventing the severity of illnesses and providing what is currently the best protection against the flu. 

The flu is more dangerous for some people than others. Children younger than five years old, elderly adults over 65, and those with compromised immune systems or chronic health problems are most susceptible to more severe complications if they contract the flu, including the risk of death.  

Pregnant women are also more susceptible to have flu-related problems. A healthy pregnancy increases the demand on a woman’s body systems, including her lungs, heart, and immune system, which puts her at greater risk of flu-related complications. 

These complications include an increased risk of pneumonia, hospitalization, preterm birth, and death, so not receiving the flu vaccine can put pregnant women and their babies at an increased risk of severe complications, including a stay in the Intensive Care Unit and death. 

One recent study shows that pregnant women who were admitted to ICU with the flu were four times more likely to deliver preterm babies and four and a half times more likely to have babies with low birth weights. Women continue to be susceptible even in the early postpartum period due to changes in the body system.

Newborns are not able to receive flu vaccinations and only receive this passive protection from their mothers receiving the flu shot during pregnancy or by breastfeeding after birth. 

Contrary to some inaccurate myths, the flu shot cannot give you the flu. This is because the flu shot is made of an inactivated virus, not from a live virus. 

Pregnant women need to avoid the “live attenuated influenza vaccine” nasal spray since this product does contain live virus. Pregnant women who believe they have the flu should contact their doctors immediately; since they may be able to administer an antiviral agent such as Tamiflu to lessen the likelihood of severe complications.

According to the CDC, 65 percent of women are not receiving recommended flu shots or TDAP vaccinations during pregnancy. The TDAP is usually given in the third trimester and protects babies from getting whooping cough. Both vaccines are recommended during each pregnancy; however, research shows that although both are regularly offered (75 percent of the time), only 35 percent of mothers reported receiving both vaccines. 

Since babies cannot be immunized until six months of age, any family member or caregiver who comes into contact with them should be vaccinated against the flu to protect them during this vulnerable time. 

Parents and family members of sick babies may not have the time or means to obtain the immunization during this crucial, yet emotional time. 

For instance, our institution is one of a few institutions that offer flu shots to each patient’s adult household family members at no cost to help protect babies against the flu. Since 2015, this Flu Crew program has provided over 250 free adult vaccinations to help protect neonatal patients. Most of the vaccinations have been administered to fathers, but also grandparents, aunts, uncles, and cousins. 

To be sure, receiving the flu shot may not stop everyone from getting the flu. Still, it can work to keep communities healthier by avoiding catastrophic flu-related illness leading to hospitalization and increasing the risk of death. 

To take the guesswork out of what each flu season will bring, people can get the flu shot and offer more certainty to everyone that the flu will not drastically change their lives. 

Christie Lawrence is an assistant professor in the College of Nursing, Department of Women, Children and Family Nursing, at Rush University, former NICU Clinical Nurse Specialist at Rush University Medical Center, and a Public Voices fellow through The OpEd Project. 

Kristen Welsh is a clinical pharmacy specialist in pediatrics and a leader of the Flu Crew multidisciplinary initiative in the Neonatal Intensive Care Unit at Rush University Medical Center.