Pregnant women need flu vaccine most, according to the World Health Organization.
When Aubrey Opdyke was pregnant with her second child in 2009, she didn't get a flu shot. It wasn't because she was afraid of vaccines or because she doesn't believe in them. She just didn't think anything of it, she said.
In June, Opdyke came down with the flu – a low grade fever and a cough – but a week later, it landed her in the hospital where she would fight for her life in a medically induced coma and eventually deliver her baby at just 27 weeks. The baby, Parker Christine Opdyke, only lived for seven minutes.
"It didn't hit people like it hit pregnant women," Opdyke said of the 2009 swine flu pandemic, which hospitalized her for three months. "I just never even thought about being vaccinated. It wasn't even an issue back then." She said her doctor didn't push her to get a flu shot.
But this flu season, the World Health Organization said pregnant women should be given top priority for flu vaccinations, putting them above the elderly, children and people with chronic health conditions.
Pregnant women are considered especially vulnerable to the flu because their immune systems are slightly depressed to accommodate the growing fetus, doctors say. The mother's body does this so her immune won't attack the unborn baby, which includes foreign DNA.
"They're not more likely to get it, but if they get it, they're more likely to have severe morbidity or actually die from it," said Dr. Jon Abramson, a pediatrician at Wake Forest Baptist Medical Center in North Carolina.
When the immune system is down, the mother's body can't fight the flu off as easily, Abramson said. It can then escalate and result in pneumonia and other health problems. Even if the flu doesn't result in hospitalization, the baby is more likely to have a low birth weight or be born premature, especially if the mother gets the flu in the third trimester.
For Opdyke, she had a 99- or 100-degree fever and a cough for a week. Her doctor told her to take Tylenol and prescribed an antibiotic, but she began to behave erratically. Her husband was concerned and took her to the hospital, where doctors learned she had extremely low oxygen levels and her lungs were full of fluid.
Doctors intubated Opdyke to get her more oxygen, but she fought it, so they put her in a coma, she said.
Through the three-month hospital stay, Opdyke's lungs collapsed six times. She developed pneumonia and acute respiratory distress syndrome.
When Opdyke's kidneys started to shut down five weeks into the induced coma, doctors had to deliver baby Parker early.
"The flu gets your body so depleted of everything that everything else can come and break you down even more," Opdyke said.
Although doctors have recommended the flu vaccine to pregnant women for decades, the 2009 pandemic got people's attention. According to a WHO report, pregnant women in New York City were 7.2 times more likely to be hospitalized for influenza than non-pregnant women during the 2009 swine flu pandemic.
Since then, Opdyke has gotten a flu shot every year, including the year she was pregnant with her baby boy, Braden.
Lori Wolfe, who directs the Texas Teratogen Information Service Pregnancy Risk Line, said more women call her because they are afraid of getting the flu shot, not the flu. Since 2009, Wolfe and her colleagues have made it a practice to always recommend the flu shot to callers.
"When women are pregnant, there's some concern about anything entering their system. The thought of having to get a vaccination alone is scary to a lot of them," Wolfe said, adding that they usually understand why it's important to get one after the teratologist explains flu risks to them.
Abramson said there's no way to get the flu from a flu shot (not the nasal spray) because the virus inside the shot is dead. Even once the baby is born, the mother's flu antibodies are passed to the baby through the placenta and protect him or her for up to six months. By then, the baby can get a flu shot, too.
Opdyke said pregnant women should get new vaccines as soon as they are available in the fall because their 8-month-old vaccines won't help them in a few flu season. In her opinion, the fear pregnant women feel about vaccines is nothing compared to what she went through without one, and she hopes women realize that flu shots aren't just hype.
"The other fear is being dead," she said. "It bothers me when there are moms out there that say 'No, no, no, never, never, never.' It's almost a slap in my face. I went through a lot."
Wolfe said a woman can get a flu vaccine at any time during her pregnancy. Other than the risk of miscarriage or premature birth if the mother is severely sick, a fever above 102 degrees presents the biggest developmental hazards to the fetus.
A Danish study published earlier this month also found a correlation between the flu during pregnancy and autism, reinforcing experts recommendations that all pregnant women should be vaccinated.