ACOG's Immunization Newsletter

Visit our 2017-2018 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. 

June Newsletter

Influenza Activity in the United States During 2017-2018 Season

The CDC’s May 25 influenza season update marked the final updated for the 2017 – 2018 season. The United States 2017 – 2018 influenza season was a high severity season. Nationally, influenza-like illness (ILI) activity began increasing in November, followed by an extended period of high activity during January and February, and remained elevated through March. Influenza A(H3N2) viruses were most common through February and predominately overall for the season. Influenza B viruses were most common from March onward.

On June 8, the CDC reported that there have been 172 pediatric deaths in the 2017- 2018 influenza season. This number exceeds the 2012-2013 season, which previously set the record for the highest number of flu-related deaths in children reported during a single flu season (excluding pandemics). Approximately 80 percent of these deaths occurred in children who had not received a flu vaccination this season. 

View CDC’s MMWR, Update: Influenza Activity in the United States During the 2017-18 Season and Composition of the 2018 - 2019 Influenza Vaccine for a summary of the Unites States influenza activity during October 1, 2017 – May 19, 2018.

Composition of the 2018-2019 Influenza Vaccine

There is not much down time between flu seasons, and it’s time to start planning for next year! The composition of U.S. flu vaccines is reviewed annually and updated to match circulating flu viruses. Flu vaccines protect against the three or four viruses that research suggests will be most common.

The Food and Drug Administration’s Vaccines and Related Biologic Products Advisory Committee (VRBPAC) recommended that the 2018 – 2019 influenza trivalent vaccine to be used in the United States contain:

  • an A/Michigan/45/2015 A(H1N1) pdm09-like virus
  • an A/Singapore/INFIMH-16–0019/2016 A(H3N2)-like virus
  • an B/Colorado/06/2017-like (B/Victoria lineage) virus

Four-component (quadrivalent) vaccines, which protect against a second lineage of B viruses, are recommended to be produced using the same viruses recommended for the trivalent vaccines, as well as a B/Phuket/3073/2013-like (B/Yamagata lineage) virus.

These vaccine recommendations were based on several factors, including global influenza virologic and epidemiologic surveillance, genetic and antigenic characterization, human serology studies, antiviral susceptibility, and the availability of candidate influenza viruses.

Visit CDC’s website for more information on how influenza (flu) vaccines are made.

ACOG’s Immunization Applet

Download the ACOG app and access authoritative information from the leading experts in women’s health care. The immunization applet is part of the ACOG app, and is a trusted and interactive resource on immunization best practices. The app includes an interactive “By Profile” feature in which recommended immunizations are generated based on the information providers enter about their patient’s age and conditions.

The app includes the 2018 CDC Adult Immunization Schedules.  

NEW! ACOG Maternal Immunization Toolkit

Visit ACOG’s Immunization for Women website to access the Maternal Immunization Toolkit, which includes:

New! ACOG Committee Opinion: Maternal Immunization

ACOG has newly released Committee Opinion 741: Maternal Immunization. Within the CO, ACOG recommends that ob-gyns and other obstetric care providers should routinely assess their pregnant patients’ vaccination status, as well as recommend, and, when possible, administer needed vaccines to these patients.

The new Maternal Immunization Committee Opinion features a maternal immunization table that summarizes recommended immunizations during pregnancy based on the CDC schedules. This table provides an easy-to-use reference to quickly assess which vaccines a pregnant woman needs and when she should receive those vaccines.


Save the Date for ACOG’s Upcoming Webinar, An Overview of Adult Immunizations for Ob-Gyn Providers

National Immunization Awareness Month (NIAM) is an annual observance held in August to highlight the importance of vaccination for people of all ages. ACOG is participating by hosting a webinar during the month of August.  

On Thursday, August 2, at 12:00 – 1:00 pm EDT (9:00 – 10:00 am PT), ACOG will offer a free, 1 CME credit webinar on adult immunizations.

This webcast will discuss vaccines recommended for routine use in adult ob-gyn patients, as well as review strategies and resources ob-gyns can utilize as they incorporate immunizations into their practice.

Register today! 

Zika Virus

See ACOG and SMFM’s Practice Advisory on Zika virus.

Regardless of location, providers should evaluate all pregnant women in the United States for possible Zika virus exposure during each prenatal care visit. This evaluation should include an assessment of signs and symptoms of Zika virus disease, a travel history and a woman's sexual partner's potential exposure.  

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), and additional links for ob-gyns.

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

Remind travelers 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.

Zika Care Connect

The Centers for Disease Control and Prevention (CDC), in collaboration with March of Dimes, has established a specialty healthcare professional network, known as Zika Care Connect (ZCC), to facilitate access to services for managing Zika. ZCC now includes a searchable member directory, an online searchable tool for ZCC members to find the phone number, email, and address of other ZCC members. The information you provide for this directory will only be accessible to other professionals with a ZCC login and not to the public. If you are already a member of the Zika Care Connect Network you can call the HelpLine for assistance joining the directory.

If you have not yet joined the ZCC network it’s not too late! To find out more about how to be included or the member directory, please contact the Program Director, Lindsay Rechtman (lrechtman@mcking.com or404-683-4394) or the Zika Care Connect HelpLine (helpline@zikcareconnect.org/ or 844-677-0447).

 

May Newsletter

Influenza Activity in the United States is Decreasing.

According to the FluView report for the week ending May 12, 2018, seasonal influenza activity remained at levels below baseline in the United States. Two states experienced low Influenza Like Illness (ILI) activity (Arizona and Puerto Rico).  

Updated! ACOG's Immunization Applet

Download the ACOG app and access authoritative information from the leading experts in women’s health care. The immunization applet is part of the ACOG app and is a trusted and interactive resource on immunization best practices. The app includes an interactive “By Profile” feature in which recommended immunizations are generated based on the information providers enter about their patient’s age and conditions..

Updated to include the 2018 CDC Adult Immunization Schedules.

ACOG Influenza Vaccination during Pregnancy Toolkit

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

Congratulations to ACOG's 2018 Immunization Champion Award Winners 

The ACOG Immunization Champion Award recognizes members who have demonstrated exceptional progress in increasing immunization rates among women. This year ACOG recognizes the hard work and dedication of three selected members who exemplify ACOG’s guidance on immunization for women.

Dr. Linda O’Neal Eckert maintains a clinical ob-gyn practice at the University of Washington, Harborview Medical Center, where she is a Professor in the Department of Obstetrics & Gynecology and Adjunct Professor in the Global Health Department. She is on ACOG’s Immunization, Infectious Disease, & Public Health Preparedness Expert Work Group, and works as a consultant to WHO and to the Bill and Melinda Gates Foundation in policy and implementation tool development for maternal immunization, and the HPV vaccine.

Dr. Meryl Y. Grimaldi, Vice Chair of St. Barnabas Hospital Ob-Gyn is a generalist ob-gyn. She works in a safety net Bronx Hospital that cares for a large multicultural medically underserved population. A comprehensive program of preconception, prenatal and postpartum vaccination is the standard of care in the department.

Dr. Sangini S. Sheth is an Assistant Professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at Yale School of Medicine. Dr. Sheth has been using dissemination and implementation science methods to successfully improve HPV vaccine utilization among patients of Yale New Haven Hospital’s obstetrics and gynecology clinic in outpatient and inpatient postpartum settings. 

Save the Date for ACOG's Zika Refresher Webinar 

On Thursday, June 14, at 12:00-1:00pm ET (9:00-10:00am PT), ACOG will offer a free, 1 CME credit, webinar on Zika.

This webcast will explain how Zika virus is contracted, prevention methods, who should be assessed for Zika virus exposure, current testing recommendations, and what follow-up is recommended for the infants of women with possible Zika virus exposure during pregnancy. Register today!

Zika Virus Update

See ACOG and SMFM’s Practice Advisory on Zika Virus.

Regardless of location, providers should evaluate all pregnant women in the United States for possible Zika virus exposure during each prenatal care visit. This evaluation should include an assessment of signs and symptoms of Zika virus disease, a travel history and a woman's sexual partner's potential exposure. 

 

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), and additional links for ob-gyns.

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

Remind travelers 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.

NEW Zika Care Connect Update!

The Centers for Disease Control and Prevention (CDC), in collaboration with March of Dimes, has established a specialty healthcare professional network, known as Zika Care Connect (ZCC), to facilitate access to services for the management of Zika. ZCC now includes a searchable member directory. The directory is an online searchable tool for ZCC members to access the phone number, email, and address of other ZCC members. The information you provide for this directory will only be accessible to other professionals with a ZCC login and NOT to the general public. If you are already a member of the Zika Care Connect Network you can call the HelpLine for assistance joining the directory.

If you have not yet joined the Zika Care Connect Healthcare Professional Network- it’s not too late! To find out more about how to be included in the ZCC Healthcare Professional Network or the Member Directory, please contact the Program Director, Lindsay Rechtman (lrechtman@mcking.com/404-683-4394) or the Zika Care Connect HelpLine (helpline@zikcareconnect.org/ 844-677-0447).

 

April Newsletter

Influenza activity in t he United States is decreasing.

According to the FluView report for the week April 15, 2018, flu activity has continued to decrease in the United States, specifically on the west coast. Most states are reporting low to minimal flu activity. In addition, five influenza-associated pediatric deaths were reported. Although flu activity is decreasing, pregnant women who have not yet been vaccinated should still receive a flu vaccine as long as flu season continues (typically through May).   

National Infant Immunization Week (NIIW)

National Infant Immunization Week (NIIW) is April 21-28, 2018.  Each year, NIIW highlights immunization achievements and the positive impact of vaccination on the lives of infants and children. Healthcare professionals are on the front lines of the fight against vaccine-preventable diseases. According to CDC research, parents consistently identify healthcare professionals as their most trusted source of immunization information. Research also shows that many parents make vaccine decisions before their baby is even born.

During NIIW, ACOG encourages you to remind parents and pregnant women about the importance of on-time infant immunization. We also encourage you to review Provider Resources for Vaccine Conversations with Parents, a suite of materials created by CDC, the American Academy of Pediatricians (AAP) and the American Academy of Family Physicians (AAFP). In addition, CDC has a slide deck you can use to with staff to discuss how to create a culture of immunization in your practice. NIIW is also a great time to watch CDC’s recent webinar Getting Parents to Yes! Vaccine Conversations That Work for Providers & Parents. Visit the NIIW website for sample social media content, talking points, website banners, and more.

UPDATED! ACOG Influenza Immunization during Pregnancy Toolkit

ACOG recently updated several components of its Influenza tool kit, including the Committee Opinion, Influenza Vaccination During Pregnancy.

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

Vaccine Research Fellowship at Kaiser Permanente Northern California 

Interested in conducting research regarding vaccines and other disease research? The Kaiser Permanente Northern California (KNC) Division of Research (DOR) is offering a full-time two-year term (with the possibility of extension) fellowship training position with its Vaccine Study Center in Oakland, California. The Fellow will work in collaboration with the Director of Kaiser Permanente Vaccine Study Center (KPVSC) to design, develop, and direct well-defined research, write and present papers, prepare grant proposals, provide consultation and direction to programmer/analyst regarding data management and analysis strategies, and collaborate on several large ongoing and multisite vaccine clinical trials and observation studies.

Required qualifications include an MD degree or equivalent, and be either board certified or board eligible in a clinical specialty.

If interested please email a letter of interest and curriculum vitae to:

Nicky Klein, MD, PhD

Director, Kaiser Permanente Vaccine Study Center

Division of Research, Kaiser Permanente Northern California

One Kaiser Plaza, 16th Floor, Oakland, CA 94612

Email:  Nicola.Klein@kp.org (cc: Laurie.A.Aukes@kp.org

In addition, you can find the link to apply on-line as well as a full description of the fellowship at https://kp.taleo.net/careersection/external/jobdetail.ftl?job=671332

ACOG’s Immunization Applet

Download the ACOG app and stay connected with authoritative information from the leading experts in women’s health care. The immunization applet is part of the ACOG app and is a trusted and interactive resource on immunization best practices. The app includes an interactive “By Profile” feature in which recommended immunizations are generated based on the information providers enter about their patient’s age and conditions.

Zika Virus Update

See ACOG and SMFM’s Practice Advisory on Zika Virus.

Regardless of location, providers should evaluate all pregnant women in the United States for possible Zika virus exposure during each prenatal care visit. This evaluation should include an assessment of signs and symptoms of Zika virus disease, a travel history and a woman's sexual partner's potential exposure. 

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), and additional links for ob-gyns.

Visit ACOG’s Zika Virus webpage 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.

NEW Zika Care Connect Update!

The Centers for Disease Control and Prevention (CDC), in collaboration with March of Dimes, has established a specialty healthcare professional network, known as Zika Care Connect (ZCC), to facilitate access to services for the management of Zika. ZCC now includes a searchable member directory. The directory is an online searchable tool for ZCC members to access the phone number, email, and address of other ZCC members. The information you provide for this directory will only be accessible to other professionals with a ZCC login and NOT to the general public. If you are already a member of the Zika Care Connect Network you can call the HelpLine for assistance joining the directory.

If you have not yet joined the Zika Care Connect Healthcare Professional Network- it’s not too late! To find out more about how to be included in the ZCC Healthcare Professional Network or the Member Directory, please contact the Program Director, Lindsay Rechtman (lrechtman@mcking.com/404-683-4394) or the Zika Care Connect HelpLine (helpline@zikcareconnect.org/ 844-677-0447).

 

February Newsletter

Taking Action to Prevent & Treat Flu, Protect High-Risk Populations: A Page from Duke’s Handbook

In response to this year’s particularly widespread and deadly influenza season, Dr. Geeta Swamy of Duke University addressed her ob-gyn colleagues in Duke’s weekly newsletter urging them to follow guidelines for prevention, identification, and treatment of influenza in pregnant women. See highlights from Dr. Swamy’s article below, and strongly consider sharing these messages with your colleagues.

“Per the CDC’s FluView weekly surveillance, flu activity is increasing with widespread activity throughout the US. While many infected individuals feel unwell for 1-2 weeks, influenza is associated with serious complications including pneumonia, hospitalization, and death in high-risk populations, namely young children, pregnant women, older and chronically ill persons.”

“The CDC and ACOG recommend that all individuals > 6 months of age receive an annual influenza vaccine as the most effective way to prevent infection.”

“It is imperative that we promptly recognize the symptoms, adequately assess severity, and readily prescribe safe and effective antiviral therapy. Symptoms of influenza infection include:    

  • Fever >100◦F (not required)
  • Cough
  • Sore throat
  • Runny nose
  • Headaches and/or body aches
  • Fatigue
  • Difficulty breathing

“As pregnant women are at high risk of serious flu-related complications, such as ICU admission, preterm birth, and maternal death, pregnant women with flu-like illness should be treated with antiviral medications presumptively, regardless of vaccination status, laboratory test result, or time since onset of symptoms.”

“The ACOG/SMFM influenza algorithm guides practitioners through the prompt assessment and treatment of flu-like illness in pregnant women including guidance on assessing severity such as dehydration, co-morbidities, O2 saturation and chest x-ray. You may want to display the algorithm in provider/staff work areas as a reminder or bookmark it on your phone web browser for quick and easy access.”

Upcoming Webinar: Maternal Immunization: Understanding Safety & Efficacy and Making a Strong Recommendation

The American College of Obstetricians and Gynecologists (ACOG), in partnership with American College of Nurse-Midwives (ACNM), The Association of State and Territorial Health Officials (ASTHO), and the Centers for Disease Control and Prevention (CDC), is presenting a webinar, Maternal Immunization: Understanding Safety and Efficacy and Making a Strong Recommendation on Thursday, March 1, 2018 at 5:00 PM ET (2:00 PM PT).

This free, 1 CME credit webinar will provide information on the safety and efficacy of maternal information and will give example of how to address these topics with patients by making a strong recommendation. The webinar will also identify resources for providers and patients regarding maternal immunizations. Continuing Medical Education credit is provided through joint providership with The American College of Obstetricians and Gynecologists. Click here to register!

ACOG’s NEW Immunization Champion Award

Are you or someone you know an immunization champion? We want to hear about your efforts! Nominate yourself or your colleague(s) for a chance to be recognized nationally as an ACOG Immunization Champion. Winners will receive a $1,500 honorarium, an award to display in their office and will be highlighted in ACOG’s Immunization Newsletter which is e-mailed to all ACOG members. Awardees will also be added to ACOG’s Immunization Champion Honor Roll on ACOG’s Immunization for Women website. Nominations will be accepted until March 1, 2018 and the winners will be selected by April 1, 2018. Submit your nomination today!

ACOG Influenza Vaccination during Pregnancy Toolkit

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

FAQ’s for Patients Concerning Influenza (Flu) Vaccination During Pregnancy,

FAQ’s for Patients Concerning Vaccine Safety,

FAQ’s Concerning Seasonal Influenza for Ob-Gyn,

Flu Vaccine Information Statement, and

ACOG’s Influenza Season Assessment and Treatment for Pregnant Women with Influenza-Like Illness

ACOG’s Immunization Applet

Download the ACOG app and stay connected with authoritative information from the leading experts in women’s health care. The immunization applet is part of the ACOG app and is a trusted and interactive resource on immunization best practices. The app includes an interactive “By Profile” feature in which recommended immunizations are generated based on the information providers enter about their patient’s age and conditions.

Zika Virus Update

See ACOG and SMFM’s Practice Advisory on Zika Virus.

Regardless of location, providers should evaluate all pregnant women in the United States for possible Zika virus exposure during each prenatal care visit. This evaluation should include an assessment of signs and symptoms of Zika virus disease, a travel history and a woman's sexual partner's potential exposure. 

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), and additional links for ob-gyns.

Visit ACOG’s Zika Virus webpage 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.

 

January Newsletter

Influenza activity in the United States is increasing

The Centers for Disease Control and Prevention (CDC) released a Health Advisory through its Health Alert Network (HAN): Seasonal Influenza A(H3N2) Activity and Antiviral Treatment of Patients with Influenza on December 27, 2017.

Importantly:

  • Influenza should be high on the list of possible diagnoses for ill patients because influenza activity is increasing nationwide.
  • All pregnant and postpartum women (up to two weeks) with suspected influenza should be treated promptly with a neuraminidase inhibitor antiviral. While antiviral drugs work best when treatment is started within 2 days of illness onset, clinical benefit has been observed even when treatment is initiated later.
  • If influenza is suspected, clinicians should not wait for test results to begin treatment with antivirals. Treatment should begin promptly.

See ACOG and SMFM’s Influenza Season Assessment and Treatment for Pregnant Women with ILI Algorithm

It’s not too late and is critical to vaccinate!

Many pregnant women have already been hospitalized with influenza-like illness this season. It is important to communicate with patients that even though the vaccine is not 100% effective, receiving an influenza vaccination can still mitigate the effects of influenza illness.

ACOG encourages providers to continue to strongly recommend influenza vaccination to all pregnant women in any trimester. In your conversation remind patients that:

  • Flu vaccination during pregnancy can prevent influenza infection in both moms and babies
  • Even if you still get the flu, receiving a flu vaccine often lessens the severity of flu symptoms and chances of hospitalization and death
  • Flu vaccination can be safely given at any time in pregnancy

See ACOG’s Practice Advisory: Influenza Vaccination During Pregnancy for more information.

ACOG Influenza Vaccination during Pregnancy Toolkit

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

FAQ’s for Patients Concerning Influenza (Flu) Vaccination During Pregnancy,

FAQ’s for Patients Concerning Vaccine Safety,

FAQ’s Concerning Seasonal Influenza for Ob-Gyn,

Flu Vaccine Information Statement, and

ACOG’s Influenza Season Assessment and Treatment for Pregnant Women with Influenza-Like Illness

January is Cervical Cancer Awareness Month

ACOG has a multitude of resources on cervical cancer for providers and patients, include important information about HPV Vaccination. Check out ACOG’s HPV Vaccination tool kit which includes:

ACOG’s Committee Opinion: Human Papillomavirus Vaccination

FAQs for Patients Concerning HPV Vaccination

Physician Script on HPV Vaccination

Infographic Poster: The HPV Vaccine is a Lifesaver

Infographic Poster: Protect Yourself with the HPV Vaccine

Infographic Poster: Protect Your Family with the HPV Vaccine

Immunization Champion Spotlight: Jennie Yoost, MD Marshall University  

Dr. Jennie Yoost, a pediatric and adolescent gynecologist at Marshall University, has worked with her team to improve Human Papillomavirus (HPV) vaccination rates among adolescents and young adults. HPV vaccination has successfully been implemented in the office practice through the following steps.

  • Education of staff and the identification of patients needing the vaccine.
  • Nurses ask every adolescent in the target or catch up age group about HPV vaccination status.
  • Electronic records are used for clinician reminders and for access to immunization records from other providers.
  • All clinic rooms contain ACOG’s “The HPV Vaccine is a Lifesaver” poster which facilitates discussion with parents and adolescents.
  • Clinic staff provide brochures such as ACOG’s “Frequently Asked Questions for Patients Concerning HPV Vaccination” to patients and parents about HPV vaccination.

In addition, Dr. Yoost is a Vaccine for Children provider and able to provide vaccination at no cost to those patients without vaccination coverage.

ACOG’s Immunization Applet

Download the ACOG app and stay connected with authoritative information from the leading experts in women’s health care. The immunization applet is part of the ACOG app and is a trusted and interactive resource on immunization best practices. The app includes an interactive “By Profile” feature in which recommended immunizations are generated based on the information providers enter about their patient’s age and conditions.

Zika Virus Update

See ACOG and SMFM’s Practice Advisory on Zika Virus.

Regardless of location, providers should evaluate all pregnant women in the United States for possible Zika virus exposure during each prenatal care visit. This evaluation should include an assessment of signs and symptoms of Zika virus disease, a travel history and a woman's sexual partner's potential exposure. 

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), and additional links for ob-gyns.

Visit ACOG’s Zika Virus webpage 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 Immunization Newsletter

Influenza activity in the United States is increasing 

Influenza activity in the United States has been increasing since the beginning of November. CDC’s recent MMWR summarizes U.S. influenza activity during October 1 - November 25, 2017.

In the United States, annual influenza vaccination can reduce the likelihood of becoming ill with influenza and transmitting the virus to others and is recommended for all persons aged ≥6 months. Annual influenza vaccination offers optimal protection regardless of whether the vaccine composition has changed since the previous season.

Almost two thirds of pregnant women have not been vaccinated against flu

According to CDC’s Pregnant Women and Flu Vaccination, Internet Panel Survey, as of early November 2017, influenza (flu) vaccination coverage among pregnant women before and during pregnancy was 35.6%.

Most pregnant women (97.9%) reported visiting a doctor or other medical professional at least once before or during pregnancy since July 1, 2017. Among these women, 58.7% reported receiving a recommendation for and offer of flu vaccination from a doctor or other medical professional, 15.6% received only a recommendation for and no offer of flu vaccination, and 25.7% did not receive a recommendation for or an offer of flu vaccination.

Health care providers are encouraged to continue to strongly recommend and offer flu shots to pregnant women throughout the flu season to protect mothers and their infants.

Make a Strong Flu Vaccine Recommendation

As a health care provider, your strong recommendation is a critical factor that affects whether your patients get an influenza vaccine. CDC suggests using the SHARE method to make a strong vaccine recommendation and provide important information to help patients make informed decisions about vaccinations.

  • S- SHARE the reasons why the influenza vaccine is right for the patient given his or her age, health status, lifestyle, occupation, or other risk factors.
  • H- HIGHLIGHT positive experiences with influenza vaccines (personal or in your practice), as appropriate, to reinforce the benefits and strengthen confidence in flu vaccination.
  • A- ADDRESS patient questions and any concerns about the influenza vaccine, including side effects, safety, and vaccine effectiveness in plain and understandable language.
  • R- REMIND patients that influenza vaccines protect them and their loves ones from serious flu illness and flu-related complications.
  • E- EXPLAIN the potential costs of getting the flu, including serious health effects, time lost (such as missing work or family obligations), and financial costs.

View the following resources to assist you in making a strong flu recommendation:

  • ACOG’s webinar: Don’t Wait, Vaccinate! Tips & Resources for Communicating with Adult Patients about Vaccination Webinar
  • ACOG’s Influenza Immunization during Pregnancy Toolkit
  • CDC’s Make a Strong Flu Recommendation Factsheet
  • CDC’s webpage, Make a Strong Flu Vaccine Recommendation
  • CDC’s Seasonal Influenza Vaccination Resources for Health Professionals

Immunization Champion Spotlight: Laura E. Riley, MD Massachusetts General Hospital

Dr. Laura E. Riley, is the Director of Obstetrics and Gynecology Infectious Disease at Massachusetts General Hospital and is one of CDC’s Flu Fighter Partners. Dr. Riley, has delivered thousands of babies and works directly with mothers to guide them through their pregnancy, providing support to ensure that mothers and their babies are healthy. She says her motivation to fight flu comes from her desire to protect her patients and family. “What I tell my patients is that it’s really important not to get the flu during pregnancy,” says Dr. Riley. She reminds patients that flu can lead to serious complications in pregnant women and that a flu shot is the best available protection for mothers and their babies.

View CDC’s Flu Fighter webpage for Dr. Riley’s suggestion on addressing vaccine hesitancy and the importance of receiving the flu shot.

ACOG's Immunization Applet

Download the ACOG app and stay connected with authoritative information from the leading experts in women’s health care. The immunization applet is part of the ACOG app and is a trusted and interactive resource on immunization best practices. The app includes an interactive “By Profile” feature in which recommended immunizations are generated based on the information providers enter about their patient’s age and conditions.

Updated! ACOG Tdap Immunization Toolkit

Visit ACOG’s Immunization for Women website to access ACOG’s Tdap Immunization Toolkit, which includes:

ACOG Influenza Vaccination during Pregnancy Toolkit

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

Zika Virus Update

ACOG and SMFM recently revised sections of their Practice Advisory on Zika Virus.

Regardless of location, providers should evaluate all pregnant women in the United States for possible Zika virus exposure during each prenatal care visit. This evaluation should include an assessment of signs and symptoms of Zika virus disease (e.g. acute onset of fever, rash, arthralgia, conjunctivitis), a travel history, and a woman’s sexual partner’s potential exposure. 

View CDC’s MMWR, Update: Interim Guidance for the Diagnosis, Evaluation, and Management of Infants with Possible Congenital Zika Virus Infection – United States, October 2017.

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), and additional links for ob-gyns.

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.

 

November Immunization Newsletter

2017-18 Flu Season

According to the FluView report for the week ending November 4, 2017, flu activity remained low overall in the United States, but is increasing. However, 6 states and Guam reported regional flu activity and 13 states reported local influenza activity.

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

Monitoring the Safety of Influenza Vaccination during Pregnancy

In order to monitor the safety of influenza vaccination during pregnancy, influenza vaccine manufacturers have developed pregnancy registries. ACOG encourages providers who administer flu vaccine to pregnant patients to participate in these registries. Please see the below links to information about each manufacturer's pregnancy registry.*

*ACOG does not preferentially recommend one brand of flu vaccine over another.

For more information about flu vaccine safety, visit ACOG’s webpage Influenza Vaccine Recommendations and Safety Information and CDC's webpage Influenza Vaccine Safety.

Tdap Vaccination Coverage During Pregnancy - Selected Sites, United States, 2006-2015

View CDC’s MMWR Tdap Vaccination Coverage During Pregnancy – Selected Sites, United States, 2006-2015 for the full report.

Tdap vaccination coverage has increased in recent years and approximately half of pregnant women in this study who had a live birth in 2015 received Tdap. Among mothers of control infants participating in the Birth Defects Study of the Slone Epidemiology Center, Tdap vaccination coverage increased from <1% before 2010 to 28% in 2013, and reached 53% in 2015. Overall, 96% of Tdap vaccinations received by pregnant women in this study were administered in physicians’ offices or clinics.

Despite this encouraging increase in rates, coverage for pregnant women remains far below the recommendation that every woman be vaccinated during each pregnancy. Increasing vaccination coverage during pregnancy could help reduce the impact of pertussis on infant morbidity and mortality.

ACOG's Immunization Applet

Download the ACOG app and stay connected with authoritative information from the leading experts in women’s health care. The immunization applet is part of the ACOG app and is a trusted and interactive resource on immunization best practices. The app includes an interactive “By Profile” feature in which recommended immunizations are generated based on the information providers enter about their patient’s age and conditions.

Updated! ACOG Tdap Immunization Toolkit

Visit ACOG’s Immunization for Women website to access ACOG’s Tdap Immunization Toolkit, which includes:

ACOG Influenza Vaccination during Pregnancy Toolkit

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

Zika Virus Update

NEW! ACOG and SMFM recently revised sections of their Practice Advisory on Zika Virus. Critical updates are below.

  • Previously, CDC recommended serial ultrasounds every 3-4 weeks for women with laboratory evidence of Zika virus infection based on existing fetal growth monitoring for other maternal conditions (e.g., hypertension or diabetes). However, there are no data specific to congenital Zika virus infection to guide recommendations for timing of serial ultrasounds; ob-gyns and other obstetric providers may consider extending the time interval between ultrasounds in accordance with patient preferences and clinical judgement.
  • If maternal testing does not suggest infection, patients should receive the same ultrasound screening as any other pregnant woman as part of standard routine prenatal care.
  • Zika virus RNA has been detected in amniotic fluid specimens; however, serial amniocenteses have demonstrated that Zika virus RNA may only be present transiently. Therefore, a negative test result on amniotic fluid cannot rule out congenital Zika virus infection.
  • For the detection of abnormalities associated with congenital Zika virus infection, the sensitivity, specificity, and positive and negative predictive value of ultrasound is unknown. There are no data specific to congenital Zika virus infection to guide ultrasound timing recommendations so timing can be individualized.
  • It is important that pediatric health care providers inquire about possible maternal and congenital Zika virus exposure for every newborn. This is now a component of the CDC pediatric algorithm that guides infant diagnosis, evaluation and management for Zika.

Regardless of location, providers should evaluate all pregnant women in the United States for possible Zika virus exposure during each prenatal care visit. This evaluation should include an assessment of signs and symptoms of Zika virus disease (e.g. acute onset of fever, rash, arthralgia, conjunctivitis), a travel history, and a woman’s sexual partner’s potential exposure. 

View CDC’s MMWR, Update: Interim Guidance for the Diagnosis, Evaluation, and Management of Infants with Possible Congenital Zika Virus Infection – United States, October 2017.

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), and additional links for ob-gyns.

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.

 

October Immunization Newsletter

2017-18 Influenza Season Kick Off

On September 28, 2017, the National Foundation for Infectious Diseases (NFID) held the 2017 Annual NFID Influenza/Pneumococcal News Conference. ACOG and other organizations were in attendance supporting annual flu prevention. Panelists delivered important messages, including an overview of the 2016-2017 influenza season and vaccination coverage estimates, information about flu vaccines available for the current season, as well as the importance of pneumococcal vaccination.

CDC, ACOG, and other partnering organizations encourage providers to administer influenza vaccine to all pregnant patients. View the letter to health care providers of pregnant women.

View CDC’s Influenza Resources

Influenza Vaccination Coverage in the U.S. for 2016-2017 Flu Season

During the 2016-17 season 53.6% of women received a flu vaccine before or during pregnancy, up just slightly from 49.9% during the 2015-16 season.

It is encouraging to see that coverage in pregnant women has been stable after the 2009 pandemic, and its continued increase is due to provider recommendation.

View CDC’s MMWR Influenza Vaccination Coverage Among Pregnant Women – United States, 2016-17 Influenza Season for the full report.

ACOG's Word of Mouth Campaign

As part of ACOG’s efforts to increase influenza vaccination rates, ACOG encourages all District and Section leaders to use their annual meetings as an opportunity to remind members about the importance of flu vaccination. ACOG has provided District leaders with information to share with their local members. If you have questions or need additional resources regarding influenza immunization, please visit ACOG’s Immunization for Women website: www.immunizationforwomen.org.

ACOG's Immunization Applet

Download the ACOG app and stay connected with authoritative information from the leading experts in women’s health care. The immunization applet is part of the ACOG app and is a trusted and interactive resource on immunization best practices. The app includes an interactive “By Profile” feature in which recommended immunizations are generated based on the information providers enter about their patient’s age and conditions.

Updated! ACOG Tdap Immunization Toolkit

Visit ACOG’s Immunization for Women website to access ACOG’s Tdap Immunization Toolkit, which includes:

ACOG Influenza Vaccination during Pregnancy Toolkit

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

Zika Virus Update

NEW! ACOG and SMFM recently revised their Practice Advisory on Zika Virus. Critical updates are below.

  • CDC no longer recommends routine Zika virus testing for asymptomatic pregnant women with possible Zika exposure that is not ongoing*. However, testing of asymptomatic pregnant women without ongoing* possible exposure should be considered using shared decision making. See more in the Assessment and Testing section.
  • Some jurisdictions (e.g. those at increased risk for local transmission) will continue to recommend Zika testing for asymptomatic pregnant women due to increased risks of transmission. Therefore, obstetric providers should check regularly with their state and local health departments for information on testing asymptomatic pregnant women without ongoing* possible exposure.

*Ongoing exposure is defined as currently living in or frequent travel (e.g. daily or weekly) to areas with Zika virus transmission

 

View CDC’s MMWR, Update: Interim Guidance for Healthcare Providers Caring for Pregnant Women and Possible Zika Virus Exposure – United States, July 2017.

View CDC’s New and Updated Clinician and Patient Resources which incorporates the new guidance!

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), and additional links for ob-gyns.

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.

 

September Immunization Newsletter

Information for the 2017-18 Influenza Season

The American College of Obstetricians and Gynecologists (ACOG) and the Centers of Disease Control and Prevention (CDC) strongly recommend all persons six months and older receive an annual flu shot. This is particularly important for pregnant women, who are at increased risk of severe disease and hospitalization related to influenza.

The composition of U.S. flu vaccines is reviewed annually and updated to match flu viruses expected to circulate. Flu vaccines protect against the three or four viruses that research suggests will be most common.

For 2017-2018, three-component vaccines contain:

  • an A/Michigan/45/2015 (H1N1)pdm09-like virus 
  • an A/Hong Kong/4801/2014 (H3N2)-like virus
  • a B/Brisbane/60/2008-like (B/Victoria lineage) virus

Four-component vaccines contain the same three strains as three-component vaccines, along with an additional B strain (B/Phuket/3073/2013-like (B/Yamagata lineage) virus.)

View CDC’s website for the primary changes and updates to the recommendations.

View CDC’s Frequently Asked Flu Questions 2017-2018 Influenza Season.

CDC's 2017-2018 Flu Season Campaign Toolkit

CDC’s seasonal flu vaccination campaign materials are available to assist partners in communicating about the importance of vaccination. This digital toolkit includes details on events/activities, sample social media and newsletter content, graphics, web assets, and media prep material. This material is downloadable, shareable, and some of the material is customizable.

National Influenza Vaccination Week (NIVW), December 3-9, 2017, focuses on highlighting the importance of influenza vaccination.

ACOG Responds to Article on Potential Link Between Flu Shot and Miscarriage Early in Pregnancy 

Association of spontaneous abortion with receipt of inactivated influenza vaccine containing H1N1 pdm09 in 2010-11 and 2011-12 was published September 2017. 

View Dr. Haywood Brown, president of the American College of Obstetricians and Gynecologists (ACOG), statement on the safety of the influenza vaccine during pregnancy. 

CDC’s Flu Vaccination and Possible Safety Signal Fact Sheet contains information about influenza and influenza vaccination during pregnancy and provides guidance on how to address concerns that patients may have about influenza vaccination. 

Updated! ACOG Tdap Immunization Toolkit

Visit ACOG’s Immunization for Women website to access ACOG’s Tdap Immunization Toolkit, which includes:

ACOG Influenza Vaccination during Pregnancy Toolkit

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

Zika Virus Update

NEW! ACOG and SMFM recently revised their Practice Advisory on Zika Virus. Critical updates are below.

  • should continue to consult CDC’s World Map of Areas with Risk of Zika when assessing patients. In many countries the epidemic is over, however Zika is still likely to be endemic in various regions of the Americas.
  • New data on currently available IgM tests shows that IgM antibodies persist for at least four months following acute infection, thus making it difficult to determine if IgM detected during pregnancy represents an infection that is recent (during pregnancy) or one that occurred before pregnancy. IgM can also persist for a prolonged period of time potentially making timing of infection with subsequent pregnancies difficult to determine.
  • The number of false positive Zika tests has risen as the prevalence of Zika has decreased, and this compounds some of the limitations of the IgM test.
  • CDC no longer recommends routine Zika virus testing for asymptomatic pregnant women with possible Zika exposure that is not ongoing*. However, testing of asymptomatic pregnant women without ongoing* possible exposure should be considered using shared decision making. See more in the Assessment and Testing section.
  • Some jurisdictions (e.g. those at increased risk for local transmission) will continue to recommend Zika testing for asymptomatic pregnant women due to increased risks of transmission. Therefore, obstetric providers should check regularly with their state and local health departments for information on testing asymptomatic pregnant women without ongoing* possible exposure.
  • The CDC now recommends concurrent IgM and NAT testing for symptomatic pregnant women with possible Zika exposure up to 12 weeks after symptom onset. Ideally, testing should be performed as soon as possible after symptoms begin. Revised testing Figure 1 & Figure 2 can be found in the Assessment and Testing module.

*Ongoing exposure is defined as currently living in or frequent travel (e.g. daily or weekly) to areas with Zika virus transmission

Regardless of location, providers should evaluate all pregnant women in the United States for possible Zika virus exposure during each prenatal care visit. This evaluation should include an assessment of signs and symptoms of Zika virus disease (e.g. acute onset of fever, rash, arthralgia, conjunctivitis), a travel history, and a woman’s sexual partner’s potential exposure. 

Please Note: Some states will continue testing asymptomatic pregnant women. Please check with your state and local health department for recommendations in your area.

View CDC’s MMWR, Update: Interim Guidance for Healthcare Providers Caring for Pregnant Women and Possible Zika Virus Exposure – United States, July 2017.

View CDC’s New and Updated Clinician and Patient Resources which incorporates the new guidance!

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), and additional links for ob-gyns.

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.

 

 

 

This website is supported by an independent educational grant from Merck and an educational grant from Sanofi Pasteur U.S. 
ACOG does not allow companies to influence its programs, publications, or advocacy positions.