Pregnant People Hit Hard by Flu But Many Remain Unvaccinated

December 9, 2022—Flu season came early this year with some of the highest hospitalization rates seen at this time of the year in a decade. Preliminary data from CDC indicate that so far this season, nearly 50% of reported flu-associated hospitalizations in women of childbearing age have been in women who are pregnant. Concerningly, flu vaccination coverage among pregnant people is more than 10 percentage points lower than this time last year and more than 20 percentage points lower than it was prior to the COVID-19 pandemic, leaving many pregnant women and their babies unprotected from flu this season. Flu activity is expected to continue for weeks, so it remains very important that people get vaccinated if they have not yet this season, especially people who are at higher risk of developing serious flu complications, like pregnant people.

The Influenza Hospitalization Surveillance Network (FluSurv-NET) is a population-based surveillance system that collects data on laboratory-confirmed flu-associated hospitalizations among children and adults through a network of acute care hospitals in 14 states. According to preliminary FluSurv-NET data, 161 out of 346 (46.5%) women 15-49 years hospitalized with laboratory-confirmed flu infection in this surveillance network as of the week ending December 3, 2022, were pregnant. Pregnant women are generally at higher risk of being hospitalized with flu, but the percentage of flu-associated hospitalizations in women who are pregnant reported to FluSurv-NET this season is higher than in previous seasons. During the 2018-2019 flu season 26.1% of hospitalized women 15-44 years were pregnant and in 2020-2021 37.4% of hospitalized women 15-44 years were pregnant. It is not clear what might be contributing to the increase in the proportion of women who are pregnant among those hospitalized with flu this season, but low flu vaccination uptake and increased testing for flu could be factors. Data on the vaccination status of the pregnant persons hospitalized in this surveillance system are not available yet.

Changes to the immune system, heart, and lungs during pregnancy may make people more prone to severe flu illness that results in hospitalization. Flu also may be harmful for a pregnant person’s developing baby. Flu vaccination during pregnancy helps protect pregnant people from flu during and after pregnancy, reducing the risk of getting flu by one-half on average and reducing the risk of being hospitalized with flu by 40%. Vaccination during pregnancy also helps protect the pregnant persons’ infant from flu in their first few months after birth when they are too young to get vaccinated and at highest risk of developing serious flu complications among all pediatric age groups. This week, CDC is reporting an additional seven flu-related deaths among children, bringing the total so far this season to 21. During most seasons, 80% of pediatric deaths are among children who were not vaccinated against flu.

Based on data from December 3, 2022, coverage among pregnant people as of the end of October 2022 is lower among all racial and ethnic groups compared to the same time last year, with the largest declines this season seen in non-Hispanic Asian pregnant persons and non-Hispanic White pregnant persons. Disparities in flu vaccination coverage by race and ethnicity also persist among pregnant persons, with non-Hispanic Black pregnant persons having the lowest flu vaccination coverage so far this season compared to other racial/ethnic groups. By race/ethnicity, flu vaccination coverage among pregnant persons was:

• 15.5 percentage points lower for non-Hispanic Asian pregnant persons (51.6% compared to 67.1%)
• 14.2 percentage points lower for non-Hispanic White pregnant persons (36.6% compared to 50.8%)
• 11.2 percentage points lower for non-Hispanic Other race/ethnicity pregnant persons (36.1% compared to 47.3%). The ‘Other’ group includes pregnant persons who are American Indian or Alaska Native, Native Hawaiian or Pacific Islander, and Multiple or Other race/ethnicities.
• 10.9 percentage points lower for Hispanic/Latino pregnant persons (34.4% compared to 45.3%)
• 5.0 percentage points lower for non-Hispanic Black pregnant persons (20.4% compared to 25.4%)

Concerns about safety are often cited by pregnant people as a reason they are reluctant to get vaccinated, yet there is substantial evidence that flu shots are safe during pregnancy. Flu shots have been given to millions of people over many years with an excellent safety record. There is a large body of scientific studies that supports the safety of flu vaccine in pregnant people and their babies, and CDC continually gathers data on this topic.

While vaccination for pregnant people is very important, everyone 6 months and older should get a flu vaccine each year for the best protection against flu. With flu activity high and expected to continue, there’s still time to benefit from the protection vaccination offers. Find a flu vaccine today: https://www.vaccines.gov/find-vaccines/.