ACOG's Influenza Season Newsletter

Visit our 2016-2017 Influenza Season page for more information such as current vaccination rates, flu distribution updates, flu vaccine composition and more!

This page is updated monthly with ACOG’s new monthly influenza season newsletter. 

March: Flu Activity is Peaking. It's Not Too Late to Vaccinate!

Flu Activity Increasing Across the Country

It's not too late to vaccinate! Flu activity is elevated across the country. Outpatient visits for influenza-like-illness are above the national baseline. Activity is expected to continue during the coming weeks. To date, influenza A (H3N2) viruses have predominated overall, but influenza A (H1N1)pdm09 and influenza B viruses have also been identified. See the full MMWR report update on influenza activity in the United States

The best way to protect yourself and your patients, especially pregnant women and their infants during the flu season, is vaccination. Influenza vaccination is recommended also for people who have already had the flu, to provide protection against other circulating strains as the influenza epidemic progresses. 

To track flu activity in your area, see the CDC's weekly flu report

Assessing and Treating Influenza-like-Illness

  • ACOG & SMFM's Algorithm for the assessment and treatment of pregnant women with influenza-like-illness
  • Antiviral Agents for the Treatment and Chemoprophylaxis of Influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP)
  • A recent large multinational register study published in BMJ found no increased risks of adverse neonatal outcomes or congenital malformations associated with exposure to neuraminidase inhibitors during embryo-fetal life. The results support previously reported findings that the use of neuraminidase inhibitors is not associated with increased risks of adverse fetal or neonatal outcomes.

Interim Estimates of Influenza Vaccine Effectiveness

On February 16, 2017 the CDC published an MMWR with the interim estimates of influenza vaccine effectiveness (VE) for the 2016-17 flu season. The report was based on 3,144 children and adults enrolled in the U.S. Influenza Vaccine Effectiveness Network (U.S. Flu VE Network) during November 28, 2016 - February 4, 2017. During this period, overall vaccine effectiveness (VE) against influenza A and influenza B virus infection associated with medically attended Acute Respiratory Illness was 48%. These interim VE estimates indicate that influenza vaccination reduced the risk for outpatient medical visits by almost half. This VE is consistent with VE expected in the early part of the annual influenza epidemic. VE assessment will continue throughout the season.

Visit ACOG's Immunization for Women website to access ACOG's Influenza Immunization During Pregnancy Toolkit, which includes:

Zika Virus Update

Access ACOG’s Zika Toolkit online! The toolkit includes ACOG’s Patient Education Zika virus infographic (also available in Spanish) and video (also available in Spanish), CDC’s Zika Screening tool and additional links for ob-gyns.

Access the most recent ACOG and SMFM Practice Advisory on Zika Virus.

NEW! ACOG's Zika Virus Practice Advisory is now available in Spanish.

Visit ACOG’s Zika Virus Updates page for up-to-date information and resources.  

Are your patients traveling to visit friends or family in areas with Zika?

Remind them to protect themselves and loved ones from mosquito bites and sexual transmission of Zika. Refer them to CDC’s Zika Travel Information page to learn what they need to know before, during and after their travel.


December: Protect Patients from Flu & Zika this Holiday Season

Zika Virus Update

NEW! Access ACOG’s Zika Toolkit online! The toolkit includes ACOG’s Patient Education Zika virus infographic (also available in Spanish) and video (also available in Spanish), CDC’s Zika Screening tool and additional links for ob-gyns.

Access the most recent ACOG and SMFM Practice Advisory on Zika Virus.

Visit ACOG’s Zika Virus Updates page for up-to-date information and resources.  

Are your patients traveling to visit friends or family in areas with Zika?

Remind them to protect themselves and loved ones from mosquito bites and sexual transmission of Zika. Refer them to CDC’s Zika Travel Information page to learn what they need to know before, during and after their travel.

National Influenza Vaccination Week: December 4-10, 2016

It’s not too late to vaccinate! With flu activity increasing and family and friends planning gatherings for the holidays, now is a great time to remind your patients to get a flu vaccine. Receiving a flu vaccine can protect your patients and their loved ones against this potentially serious disease.

ACOG recommends that all Ob-gyns recommend and offer flu vaccine to all their patients, especially pregnant patients who are at increased risk of serious illness due to seasonal influenza. As a reminder, pregnant patients should always receive inactivated flu vaccine. See ACOG’s Influenza Immunization During Pregnancy Committee Opinion for additional information and share CDC’s Pregnant? Get a Flu Shot! Webpage with your patients.

If your office does not administer flu vaccine, refer your patients to HealthMap Vaccine Finder to find a flu vaccine near them.

Key Messages to share with your patients

  • Flu vaccination can reduce flu illnesses, doctor visits, pneumonia, need for antibiotics, missed work and school due to flu, as well as prevent flu-related hospitalizations.
  • Flu vaccination also may make your illness milder if you do get sick.
  • Getting vaccinated yourself also protects people around you, including those who are more vulnerable to serious flu illness, like babies and young children, older people, and people with certain chronic health conditions.
  • While seasonal flu outbreaks can happen as early as October, flu activity is usually highest between December and February, though activity can last as late as May.
  • As long as flu activity is ongoing, it’s not too late to get vaccinated!

View all NIVW Key Messages from CDC at:

Additional information and resources for NIVW can be found at:

Visit ACOG’s Immunization for Women website to access ACOG’s Influenza Immunization During Pregnancy Toolkit, which includes:

New Evidence Reinforcing Flu Vaccine Safety

The article Association Between Influenza Infection and Vaccination During Pregnancy and Risk of Autism Spectrum Disorder, published online 11/28/16 detailed a retrospective cohort study of maternal influenza vaccination, maternal influenza infection, and autism. The study found no association between maternal influenza infection or maternal influenza vaccination and autism.

Ousseny Zerbo, PhD1; Yinge Qian, MS1; Cathleen Yoshida, MA1; et al. Association Between Influenza Infection and Vaccination During Pregnancy and Risk of Autism Spectrum Disorder. JAMA Pediatr. Published online Nov 28, 2016. doi:10.1001/jamapediatrics.2016.3609


October: Zika Virus Guidance, Flu Season & HPV Vaccination Updates

Zika Virus Update

ACOG and SMFM revised sections of their Practice Advisory on Zika Virus October 18, 2016 including updates pertaining to travel restrictions, reproductive counseling, testing, and postnatal management.  

Pregnant women should consider postponing travel to all areas of Miami-Dade County, FL. Pregnant women should specifically avoid travel to the identified 4.5-square-mile area of Miami Beach and one-square-mile area in Little River located in Miami-Dade County.

The Texas Department of State Health Services issued a media release reminding pregnant women who cross the border with Mexico that Zika virus testing is available to them and encourages them to discuss testing with their health care providers.

Visit ACOG’s Zika Virus Updates for up-to-date information and resources.  

Prepare for Flu Season!

Flu season is upon us and ob-gyns should start to vaccinate as soon as vaccine is available.

According to the FluView report for the week ending October 15, 2016, flu activity is low overall in the continental United States, with only Guam reporting widespread flu activity. Influenza A (H3) viruses were most commonly reported during week 41. While the timing of influenza activity varies and is unpredictable, flu activity often begins to increase in October. CDC recommends that everyone 6 months of age and older get an annual flu vaccine before the end of October, if possible.

As stated in the October 1 Dear Colleague letter from the CDC:

As a health care provider, you know the value of prevention and its benefits on your patients’ health. Influenza vaccine has been shown to reduce the overall risk of flu-associated illness, medical visits and flu-related complications, including hospitalizations.. Vaccination is especially important for people with certain underlying medical conditions, pregnant women, the very young, and the elderly.

Click here for the full Dear Colleague letter from the CDC.

Immunization Webinar

The ACOG webinar Integrating Immunization in the Ob-Gyn Practice: Practical Tips and Resources is now available online. In this free webinar, Dr. Linda Eckert provides practical tips and resources for incorporating immunizations into routine practice. Current recommendations for Tdap, hepatitis B, influenza, zoster and pneumococcal vaccinations for pregnant and non-pregnant patients are reviewed and common patient concerns and misconceptions are addressed. Brief immunization-related patient scenarios are also presented.

ACOG Flu Season Resources:

Continuing Medical Education Opportunities

New Immunization Maintenance of Certification Part IV Modules
now available from ABOG
ACOG Immunization and Practice staff helped develop MOC Part IV Modules on pneumococcal and zoster vaccines for ABOG’s consideration to enhance ob-gyns’ immunization knowledge and practice.

CDC NetConference on Vaccines in Pregnancy

Vaccines recommended during pregnancy have a strong record of safety and effectiveness, yet low rates of vaccination persist. Health care providers can play a pivotal role in this issue. On Wednesday, Nov. 9, 12-1 ET join maternal vaccination safety experts for the next Current Issues in Immunization NetConference—Vaccines during Pregnancy: A Strong Record of Safety.
Free continuing education is available, but attendance is limited! To register, visit:

HPV Vaccination Schedule Update

On October 19th CDC recommended that 11- to 12-year-olds receive two doses of HPV vaccine at least six months apart rather than the previously recommended three doses to protect against cancers caused by human papillomavirus (HPV) infections. Teens and young adults who start the series later, at ages 15 through 26 years, will continue to need three doses of HPV vaccine to protect against cancer-causing HPV infection. This 2-dose schedule for young adolescents was voted on at the October Advisory Committee on Immunization Practices (ACIP) meeting and CDC Director Frieden approved the committee’s recommendations shortly after the vote. ACIP recommendations approved by the CDC Director become agency guidelines on the date published in the Morbidity and Mortality Weekly Report (MMWR). Click here to read the full CDC press release. ACOG is reviewing its clinical guidance for possible updates in light of these new CDC/ACIP recommendations.

September: Prepare for Flu Season

Flu season is upon us and ob-gyns should start to vaccinate as soon as vaccine is available.

The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) and the American College of Obstetricians and Gynecologists (ACOG) recommend that all adults, including pregnant women receive an annual influenza vaccine.

Updates for the 2016-17 Flu Season:

  • Interim recommendation that LAIV4 (nasal spray vaccine) should not be used this season due to concerns about its effectiveness
  • Egg-allergic recipients no longer need to be observed for 30 minutes post-vaccination, except if it is a severe form (see below). Providers should consider observing all patients for 15 minutes after vaccination to decrease the risk for injury should they experience syncope.
  • Persons with a history of severe allergic reaction (hypersensitivity reaction more severe than hives alone) to egg should be vaccinated in an inpatient or outpatient medical setting under the supervision of a health care provider who is able to recognize and manage severe allergic conditions.

For more information, read the MMWR “Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices, United States, 2016–17 Influenza Season” published August 26, 2016.

ACOG Flu Season Resources:

  • FAQ Tear Pads for Patients Concerning Flu Vaccination During Pregnancy

“Time to Think About Your Baby’s Vaccines”

Dr. Messonnier, Director of the National Center for Immunization and Respiratory Diseases wrote an article for your pregnant patients titled “Time to Think About Your Baby’s Vaccines.” The article highlights the importance of vaccines during pregnancy and suggests that pregnant women find a pediatric provider to learn more about infant immunizations before their baby arrives.

Share this article with your pregnant patients by adding the link to your website or sending it out in your regular communication channels:


August is National Immunization Awareness Month!

During August, we celebrate National Immunization Awareness Month (NIAM) and highlight the importance of vaccination for people of all ages. This is the perfect time to remind your pregnant patients to start learning about the safe, proven disease protection that vaccines will provide to their babies once they are born.  Encourage them to find and meet with a pediatric provider before their baby is born, so they can get information about vaccines that their newborn will need in the first months of life and ask any questions they may have.  You can also refer them to CDC’s newly redesigned website for parents, which contains credible information about vaccines, vaccine-preventable diseases, how to make shots less stressful, vaccine safety, and more.

NIAM is also a great reminder to make a strong recommendation for flu and whooping cough vaccines during pregnancy.  Women can get the flu shot at any time during their pregnancy, and even though it’s not flu season yet, you can let your pregnant patients know that you recommend they get the vaccine as soon as it becomes available.  Pregnant women should also get a dose of Tdap during their pregnancies “ideally between 27-36 weeks of pregnancy” to pass some whooping cough protection on to their babies.  Women who are thinking of conceiving also may need some vaccines.  For example, they should make sure they are up to date on their measles-mumps-rubella (MMR) vaccine.  This one is important because rubella is a contagious disease that can be very dangerous during pregnancy.  In fact, it can cause a miscarriage or serious birth defects.  The best protection against rubella is MMR vaccine, but pregnant women need to get it at least four weeks before getting pregnant.  Visit CDC’s new website with tips for how to talk with pregnant patients about vaccines

You can also refer women to CDC’s new website about pregnancy and vaccination which features a new quiz on Vaccines for Pregnant Women. Help your patients learn more about the vaccines they need during pregnancy by sharing this link on your website or social media accounts:

NIAM is sponsored by the National Public Health Information Coalition, in collaboration with the Centers for Disease Control and Prevention. Visit the NIAM website for more information about how to observe this important month in your practice.  

Pregnancy & Flu Vaccine

ACOG’s Committee Opinion 608: Influenza Vaccination During Pregnancy recommends that all adults receive an annual influenza vaccine. It is particularly important that women who are or will be pregnant during influenza season receive an inactivated influenza vaccine as soon as it is available.

To learn more visit:
2016-2017 Flu Season &
Flu & Pregnancy

A recent study published in the Lancet, concluded that “Trivalent inactivated influenza vaccine elicited robust antibody responses and women and their infants were significantly protected against laboratory-confirmed influenza.”

Strategies for Health care providers for making a strong vaccine referral to pregnant women.

ACOG Resources Available:

 ACOG has a limited supply of the following resources available, free of charge. If you are interested in receiving a copy please email


ACIP Vote on LAIV Recommendation for 2016- 2017:

CDC’s Advisory Committee on Immunization Practices (ACIP) voted in favor of an interim recommendation that live attenuated influenza vaccine (LAIV), also known as the “nasal spray” flu vaccine, should not be used during the 2016-2017 flu season. ACIP continues to recommend annual flu vaccination, with either the inactivated influenza vaccine (IIV) or recombinant influenza vaccine (RIV) for everyone 6 months and older. The ACIP vote follows data showing poor or relatively lower effectiveness of LAIV from 2013 through 2016. For more information, see the CDC Media Statement and Medscape Article

The 2016-2017 Influenza Vaccine Composition:

The FDA endorsed the WHO-recommended vaccine viruses for use in all U.S. seasonal flu vaccines for the 2016-2017 flu season. It was recommended that trivalent vaccines for use in the 2016-2017 influenza season (Northern Hemisphere winter) contain the following:

  • an A/California/7/2009 (H1N1) pdm09-like virus;
  • an A/Hong Kong/4801/2014 (H3N2)-like virus;
  • a B/Brisbane/60/2008-like virus (B/Victoria lineage).

 It was recommended that quadrivalent vaccines contain the above three viruses and a B/Phuket/3073/2013-like virus (B/Yamagata lineage).


Updated 3/21/17

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