A recent article in the news highlights an important problem: Even when a pregnant woman wants to get the flu shot, she may be unable to get one.  Most ob/gyn physicians do not even offer the flu shot.  Many pregnant women only see an ob/gyn physician and have stopped seeing their regular doctor even if they had one.  Also, this is compounded with the fact that many people do not even have health insurance.  The news article even states that pharmacies will balk at filling a doctor’s prescription for a flu shot.

The article can be found on MSNBC here.

Pregnant women struggle to find flu vaccine

Only 1 in 7 are protected; many obstetricians don’t offer the shot

The Associated Press

updated 3:16 p.m. CT, Mon., Sept . 28, 2009

WASHINGTON – It’s hard for pregnant women to escape the message: You’re at extra risk from swine flu — it could trigger premature labor, hospitalize you for weeks, even kill you — so be among the first in line for vaccine next month. But only about one in seven pregnant women gets a flu shot each winter.

While federal health officials are working hard to raise that number this year, repeated swine flu warnings won’t automatically overcome a key obstacle: Many obstetricians don’t vaccinate. And not only are many women reluctant to go hunting for flu shots elsewhere, historically some pharmacists and other providers have been wary of vaccinating them.

“Maybe this year we can change that culture,” says Dr. Anne Schuchat of the Centers for Disease Control and Prevention. “It’s not supposed to happen that you, when you are pregnant, are fighting for your life on a respirator.”

Yet getting simple vaccine information took Charla Bason of Washington, D.C., repeated requests, as she was bounced between her obstetrician’s office and her primary care doctor a few weeks ago.

“I feel like if I hadn’t brought it up, they never would have mentioned it to me,” says Bason, 30, who is seven months pregnant with her first child.

‘Incredibly frustrating’
Bason decided to seek vaccination after watching a CDC Webcast about pregnant women and talking with a physician in the family. But she still has no clear answer about where to get one.

“It’s been incredibly frustrating. There’s a terrible disconnect between the message that was getting out and, once you decide you want it, how do you get it?” she says.

Any kind of flu is risky during pregnancy, and pregnant women have been on the get-a-flu-shot priority list for years. Their reluctance to take any medication during pregnancy is part of the reason for the low vaccination rates.

With swine flu, what doctors call the 2009 H1N1 strain, pregnant women seem at particular risk for complications. Pregnant women make up 6 percent of H1N1-confirmed deaths even though they account for only 1 percent of the population, according to the CDC. They’re at least four times as likely to be hospitalized as other flu sufferers.

Vaccine is a two-for-one deal during pregnancy: It can protect not just mom but the baby, too, for the first few months after birth. The mother’s body makes flu-fighting antibodies that easily cross the placenta to be carried by the fetus, explains Dr. Neil Silverman of the University of California, Los Angeles. That’s important because flu can easily kill newborns, yet babies can’t be vaccinated until they’re 6 months old.

OBs may not get any swine flu shots
Once women get that vaccine advice, where do they get the shot?

The American College of Obstetricians and Gynecologists has no count of how many OBs offer flu vaccine. It’s still considered a minority although recent surveys suggest many more may be starting this year, especially in large cities.

An extra complication: Each state’s health department ultimately will decide who gets to offer the H1N1 vaccine, aiming for locations that vaccinate the most people. Those decisions haven’t been made public yet. Even if your OB requested swine flu shots, he or she may not get any, at least from initial shipments.

So the CDC and ACOG are urging obstetricians to partner with a nearby site — a hospital or drugstore, for example — to guarantee their patients a flu-shot source, a message the government will reiterate Tuesday in a swine flu training seminar for obstetricians nationwide.

Yet providers who don’t routinely treat pregnant women may not understand flu’s risk and the shot’s safety record, says Silverman, who helps set ACOG practice guidelines.

Take pharmacists, expected to be key H1N1 vaccinators. Silverman gets occasional phone calls from women who say a pharmacist won’t fill the flu-shot prescription he wrote.

“They act like the doctor who prescribed it didn’t know what he or she was doing,” says Silverman, who settles the standoff by getting the pharmacist on the phone. For every patient who calls, “I know there are at least two who just say, ‘Well, OK, I’m not going to do this,’ and just walk away.”

Some pharmacists may balk
The American Pharmacists Association is urging its members to follow the CDC’s pregnancy guidelines but can’t mandate that, and a few stores may still balk, says association chief of staff Mitchel Rothholz.

But some are embracing the potential customers. The large Walgreen’s drugstore chain told states that if picked as an H1N1 shot site, it might put get-vaccinated-here signs next to the pregnancy tests, or print vaccine reminders for people who bought prenatal vitamins.

And Louisiana this month lifted its requirement that pharmacists vaccinate by prescription only, making it easier for everyone to get a drugstore flu shot.

Why don’t more OBs vaccinate? Largely it’s the expense and hassle, but it’s not part of routine obstetrician training, says Dr. Stanley Gall of the University of Louisville, an OB and longtime vaccine provider. That’s changing as more stock a different vaccine — against the virus that causes cervical cancer — and decide they might as well offer flu vaccine, too.

Because so few pregnant women even have another doctor, “the OB office should be a one-stop shop,” he says.

 I called the Walgreen’s in Oak Park, IL, and this is what they had to say:  “You don’t even need a prescription.  You can just walk in and get it.”

Yes, but you would have to pay Walgreen’s the $29.95.  How convenient.  But what if you have a health insurance plan that would cover it?

The pharmacist said, “We can run it through and see if the insurance will cover it.  If they cover it, then we can have the insurance cover it.”

So there you have it.  If you’re pregnant and your ob/gyn refuses to give you the flu shot or a prescription for a flu shot, simply walk into the Walgreen’s store near you, show them whatever insurance would have covered the flu shot if your doctor would have given it to you, and then get it from Walgreen’s under your insurance policy.

Next on the 3D ultrasound blog, I will try this out, and we can see if the above statement is actually true.

The Walgreen’s website has specific information for pregnant women who want to get the flu shot.

Can pregnant women get a flu shot at Take Care Clinics?

Yes – Take Care Clinics offer preservative-free flu vaccines to pregnant women in their 2nd and 3rd trimester who present with a note for the flu vaccine from their Ob/Gyn. Our goal is to ensure the safe administration of vaccines to pregnant women in collaboration with the Ob/Gyn, promoting continuity of care. Preservative-free flu vaccinations are available for $29.99/dose.

So is this news article highlighting an actual difficulty?  If you are pregnant and you are finding it hard to get a flu shot, we would love to hear from you.

Note: First Peek Ultrasound serves pregnant women in the Chicago area for the services of the Baby Heartbeat Package, 3D and 4D ultrasounds, and prenatal massage.  We do not offer flu shots.

Tags: 3D ultrasound, 3D ultrasound Chicago, Chicago 3D ultrasound, flu shot, H1N1, Pregnancy, swine flu, Walgreens