The swine flu vaccine is now available from GPs' surgeries across the country and pregnant women are one of the priority groups being encouraged to have the jab.
However, you've probably read lots of stories in the news about whether the swine flu vaccine (also known as the H1N1 vaccine) is safe for your unborn baby. But with the death of six pregnant women in the UK from swine flu, you're more than likely finding the decision about whether you should or shouldn't have the vaccine a difficult one to make. So, to help make the decision easier, we've brought you the lowdown about the swine flu vaccine in pregnancy.
Why are pregnant women being encouraged to have the vaccine?
During pregnancy the immune system is naturally suppressed which makes it more likely for mums-to-be to catch swine flu. It also means that there is greater risk of developing complications and pregnant women are five times more likely to need hospital treatment.
Is the swine flu vaccine safe for pregnant women?
The Department of Health have declared the vaccine safe for expectant mums and say that it could even give your baby some protection against the disease. "We recognise that a few recent media stories have caused anxiety and apprehension for some pregnant women about receiving the swine flu vaccine," says the Director of Immunisation at the Department of Health, Professor David Salisbury. "But both the vaccines being used in the UK have been licensed for use in pregnant women. Licensed vaccines, including influenza vaccines, are held to a very high standard of safety and the vaccines would not be licensed if they were thought to be unsafe."
So what are the concerns about the vaccine's safety?
Many mums-to-be are concerned that the swine flu vaccine has not been adequately tested. A US survey found that although 43% of pregnant women and mums of children under 2 plan to get the seasonal flu jab this year, only 27% are planning to have the swine flu vaccine.
Studies in the UK have not had long-term follow-up and have only included 340 people. "There is therefore no guarantee that the vaccine is safe," said Dr Ann Robinson in The Guardian. "All one can say is that there is a very high probability that you will be at less risk from the vaccine than the disease, especially if your immune system is compromised."
Although the swine flu vaccine hasn't specifically been tested on pregnant women, many women who took part in trials for other flu vaccines with similar ingredients fell pregnant shortly after having the vaccine or were given the vaccine before they knew they were pregnant. From these women, there is no evidence that the vaccine's ingredients are a risk to the mum or her baby.
There have also been some concerns over the use of the mercury containing preservative thiomersal, which is found in the swine flu vaccine offered in the UK. Exposure to mercury in the womb has been linked to learning disabilities and hyperactivity. However, there is no firm evidence that thiomersal is harmful to mum or baby. A recent study found no link between neuropsychological functioning at the age of 7 to 10 years and exposure to mercury in the womb or during the first seven months of life. Rates of autism in the US also continued to rise even after thiomersal was removed from childhood vaccines.
I've already had swine flu, do I still need the vaccine?
"If you've already had swine flu, then it might not be necessary to have the vaccination," says Sue Macdonald, Education & Research Manager at the Royal College of Midwives. "However, because it's impossible to say who has definitely had swine flu, the vaccine will be offered to all pregnant women." It's perfectly safe to receive the vaccine if you have already had swine flu.
Can I wait and see if I get swine flu and get antiviral treatment then?
"The guidance is that it is better to have the flu vaccination," says Sue. "This would appear on balance to be a better alternative than taking the anitviral medication once you have the infection. Antivirals have side effects of their own and only shorten the illness by about a day."
Are there any side-effects of the swine flu vaccine?
"Some reactions such as soreness over the injection site, tiredness, fever and headache have been reported, but these diminish within a couple of days," explains Sue. "The vaccine does not cause flu itself, as it uses an inactive virus."
Sue also warns that if you have previously suffered a confirmed anaphylactic reaction to a vaccine, you should not have the swine flu vaccine. And, if you have an egg allergy, some brands of swine flu vaccine use eggs in their manufacture so make sure you tell your doctor and you'll be given an alternative vaccine.
Where can I get the vaccine?
If you're pregnant, your doctor should write to you about coming in to your surgery for the vaccine. They will also be able to give you further information if you have any questions or concerns. The vaccines are licensed for use at any stage of pregnancy.
How many doses do I need?
It's been recommended that pregnant women should be given a brand of swine flu vaccine that gives adequate levels of antibodies after a single dose. A single dose will also provide faster protection than two doses given three weeks apart.
Am I being irresponsible if I don't get the vaccine?
"All expectant mums want the best for their baby and this involves weighing up the balance of benefit and risk," says Professor Salisbury. "We have no reason to believe there is a risk of harm from giving the swine flu vaccines in pregnancy, but we can see clear evidence of potential harm for both the mother and baby from contracting swine flu in pregnancy. Anyone who is worried about making this choice can talk it through with their GP."