Pregnant women struggle with decision to get flu vaccination

<p>Christina Mortensen describes herself as obsessed about her health and the well-being of her unborn baby.</p><p>Due in April with her first child, Mortensen doesn't drink coffee or alcohol. She has never smoked. She uses gobs of hand-sanitizer and won't eat red meat that is not organically produced.</p><p>And she would not consider eating a tuna sandwich for fear of ingesting mercury that she believes could harm the neurological development of her fetus. </p><p>Yet on Wednesday, the 35-year-old law school student extended her arm and was injected with the swine flu vaccine that contains thimerosal — a mercury-based preservative that until last week was prohibited by California law from being injected into pregnant women and children younger than three years.</p><p>“You balance the risks,” she said. “I'm not going to do a baby any good with a 104-degree fever, lying in a hospital bed getting pumped through with chemicals.”</p><p>Pregnant women and children younger than three are considered particularly high risk for contracting the swine flu.</p><p>At least four pregnant women in California have died from swine flu and the incidence of hospitalization for pregnant women has been at least four times higher than that of the general population, according to Dr. Mark Horton, California's public health officer.</p><p>To date, there have been more than 3,500 swine flu-related hospitalizations, and 233 deaths.</p><p>Those numbers led the state last week to declare an emergency exemption on the mercury ban for pregnant women and young children “based on a current shortage of supply of mercury-free vaccine,” according to the state department of health.</p><p>Batches of mercury-free vaccine are coming, but officials don't know when, nor do they know how much will arrive.</p><p>That uncertainty is leaving a lot of parents, pregnant women and even physicians and health care officials scrambling to decide between chancing contracting the flu and getting a vaccine which up until a week ago was banned out of fear of a link to neurological disorders.</p><p>“Those affects are unknown. There is speculation, but it is basically unproven and unknown, so we want our patients to know that,” said Roberto de Bara, chief medical officer for Sutter Medical Group of the Redwoods.</p><p>For new mom Laura Robinson of Petaluma, there are real worries with either decision.</p><p>“I have fears,” she said of having her 7-month-old son, Brayden, get the shot. “I don't know if I feel comfortable putting mercury into his body.”</p><p>She has an appointment to get the vaccine Saturday, but is now leaning toward canceling it. She has consulted her pediatrician, family members who are doctors, friends who are parents and done her own research, but she remains uneasy.</p><p>“It just seems like it's not something we would want to put in our body, especially when he hasn't built up his immunity,” she said.</p><p>Robinson is not alone.</p><p>“It has definitely been confusing for people,” said Dr. Natasha Kahl, director of high risk obstetrics at Sutter hospital.</p><p>Even so, Kahl is recommending the shot for her patients.</p><p>“If we knew we were going to have the mercury-free (vaccine) tomorrow, would it make sense to wait? I guess so, but taking the risk of contracting the flu in the next three to four weeks is definitely a calculated risk,” she said.</p><p>The risks associated with contracting swine flu for pregnant women and young children are so acute, according to Dr. Mark Netherda, the county's deputy health officer, that he recommends getting the vaccine whether it has mercury in it or not.</p><p>“With this particular flu, we know that a pregnant woman is about four times more likely to have complications from H1N1,” he said. </p><p>“I personally and professionally am not convinced thimerosal poses a risk,” he said. “People probably get more mercury eating fish from the sea than from all the vaccines in their life.”</p><p>Still, Netherda said women and parents should consult their personal physicians with any concerns.</p><p>“Preservative-free (vaccine) is anticipated to become available, but in what amount and when is not particularly clear,” he said.</p><p>According to the Centers for Disease Control, “there is no evidence that thimerosal is harmful to a pregnant woman or a fetus...CDC recommends that pregnant women receive the flu vaccine with or without thimerosal.”</p><p>It is not the first time the ban has been lifted since it became law in 2004.</p><p>In 2006, the mercury prohibition was temporarily lifted when the state department of health was concerned not enough thimerosal-free vaccine would be available during a flu scare.</p><p>But the state's exemption hardly puts concerns to rest.</p><p>When Sutter opened its vaccine clinic Wednesday, some pregnant women, including Mortensen, were initially turned away by health care providers who were unclear how to proceed with the changing rules.</p><p>By midday, Sutter developed a policy which requires pregnant women and parents of children younger than three to have a signed consent form indicating they have discussed the inoculation with their doctor.</p><p>“One needs to weigh the risks and benefits,” de Bara said.</p><p>Officials at St. Joseph Health System Sonoma County are asking their pregnant employees who want the shot to consult their physician prior to getting inoculated, said spokeswoman Vanessa deGier.</p><p>The doses that arrived this week at St. Joseph facilities were labeled with a warning: “It is not known whether these vaccines can cause fetal harm when administered to a pregnant woman or affect reproduction capacity. Influenza A (H1N1) 2009 Monovalent Vaccine should be given to a pregnant woman only if clearly needed.”</p><p>Health care officials acknowledged the steady influx of information and warnings can confuse and even overwhelm the public.</p><p>“This has been a moving target,” de Bara said. “Information changes weekly, if not daily, in terms of how we treat H1N1 vaccination.”</p>