Flu & Pregnancy

Influenza is more likely to cause severe illness in pregnant people than in people of reproductive age who are not pregnant. Changes to the immune system, heart, and lungs during pregnancy make people more susceptible to influenza severe enough to cause hospitalization throughout pregnancy and up to two weeks postpartum. Influenza also may be harmful for the developing baby. A common influenza symptom fever may be associated with neural tube defects and other adverse outcomes for a developing baby. Parental vaccination also can help protect a baby from influenza after birth (because antibodies are passed to a developing baby during pregnancy).
A Flu Vaccine is the Best Protection Against Flu
Getting an influenza (flu) vaccine is the first and most important step in protecting against flu. Pregnant people should get a flu shot and not the nasal spray flu vaccine. Flu shots given during pregnancy help protect both the pregnant parent and the baby from flu. Vaccination has been shown to reduce the risk of flu-associated acute respiratory infection in pregnant people by up to one-half. A 2018 study showed that getting a flu shot reduced a pregnant person’s risk of being hospitalized with flu by an average of 40 percent. Pregnant people who get a flu vaccine also are helping to protect their babies from flu illness for the first several months after their birth, when they are too young to get vaccinated. A list of recent studies on the benefits of flu vaccination for pregnant people is available.
September and October are generally good times to be vaccinated. Early vaccination also can be considered for people who are in the third trimester of pregnancy, because this can help protect the baby after birth during their first months of life (when they are too young to be vaccinated). Some children need 2 doses given at least 4 weeks apart (children 6 months through 8 years of age who either have never received flu vaccine, or who have not already received a total of at least 2 doses in their lives). These children should get their first dose soon after vaccine is available, so that they can receive the second dose (which has to be given at least 4 weeks after the first) by the end of October.

Vaccinating Pregnant People Protects Pregnant Parents and Their Babies
Note: There is no recommendation that pregnant people or people with pre-existing medical conditions need to get special permission or written consent from their doctor or health care professional for influenza (flu) vaccination if they get vaccinated at a worksite clinic, pharmacy, or other location outside of their physician’s office. Pregnant people should not get nasal spray vaccine. For more information, visit Misconceptions about Seasonal Flu and Flu Vaccines.
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Everyone 6 months of age and older needs a flu vaccine.
Other Preventive Actions
In addition to getting a flu shot, pregnant people should take the same everyday preventive actions CDC recommends for everyone, including avoiding people who are sick, covering coughs, and washing hands often. In addition, breastfeeding also has many benefits, including helping to protect infants from infections like flu.
Symptoms and Treatment
If you get flu symptoms call your health care provider right away. There are flu antiviral drugs that can treat flu illness and prevent serious flu complications. CDC recommends prompt flu antiviral treatment for people who have confirmed or suspected flu infection and who are at higher risk of serious flu complications, such as pregnant people. Early treatment of flu in hospitalized pregnant people has been shown to reduce the length of the hospital stay.
Symptoms
Flu symptoms include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, and fatigue. Some people may also have vomiting and diarrhea, though this is more common in children than in adults. People may be infected with flu and have respiratory symptoms without a fever.
- Influenza antiviral drugs are medicines that fight against flu by keeping flu viruses from making more viruses in your body.
- Antiviral drugs can make your flu illness milder and make you feel better faster. They may also prevent serious health problems that can result from flu illness.
- Treatment with an influenza antiviral drug should begin as soon as possible because these medications work best when started early (within 48 hours after symptoms start).
- You need a prescription from a health care provider for an influenza antiviral medication.
- There are four FDA-approved flu antiviral drugs recommended by CDC this season that can be used to treat the flu.
When to Seek Emergency Medical Care
If you are pregnant and have any of these signs, call 911 right away:
- Difficulty breathing or shortness of breath
- Persistent pain or pressure in the chest or abdomen
- Persistent dizziness, confusion, inability to arouse
- Seizures
- Not urinating
- Severe muscle pain
- Severe weakness or unsteadiness
- Fever or cough that improve but then return or worsen
- High fever that is not responding to Tylenol® (or store brand equivalent)
- Decreased or no movement of your baby
This list is not all inclusive. Please consult your medical provider for any other symptom that is severe or concerning.
- Study: Influenza Vaccine Effectiveness in Preventing Influenza-Associated Hospitalizations during Pregnancy: A Multi-Country Retrospective Test Negative Design Study, 2010-2016. Clinical Infectious Diseases. 2018
- Study: Influenza Vaccination of Pregnant Women and Protection of Their Infants The New England Journal of Medicine. 2014
- Study: Maternal immunisation with trivalent inactivated influenza vaccine for prevention of influenza in infants in Mali: a prospective, active-controlled, observer-blind, randomised phase 4 trial. The Lancet Infectious Diseases. 2016
- Study: Effectiveness of seasonal trivalent influenza vaccine for preventing influenza virus illness among pregnant women: a population-based case-control study during the 2010-2011 and 2011-2012 influenza seasons. Clinical Infectious Diseases. 2014
- Study: Effectiveness of maternal influenza immunization in mothers and infants. The New England Journal of Medicine. 2009
- Study: Year-round influenza immunisation during pregnancy in Nepal: a phase 4, randomised, placebo-controlled trial. The Lancet Infectious Diseases. 2017
- Study: Benefit of Early Initiation of Influenza Antiviral Treatment to Pregnant Women Hospitalized with Laboratory-Confirmed Influenza The Journal of Infectious Diseases. 2016