The experts weigh in—plus clear up when it’s safe to get the vaccine.

Flu Pregnancy
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When you’re pregnant, you’ll hear a whole list of dos and don’ts: Do take your prenatal vitamins. Don’t drink too much coffee. Do work out (carefully). Don’t eat too much fish. But for parents-to-be who are pregnant during the thick of cold and flu season, catching the flu isn’t exactly a do or don’t choice.

Sure, there are some easy things you can do to try and avoid the flu. Washing your hands a lot and keeping them away from your face can help, for instance. But what about the influenza vaccine? It’s arguably the most important preventative measure you can take to avoid the flu each year, but you may wonder if getting a flu shot while pregnant is safe for your fetus. And it might be hard to find good information. “It’s crazy because other doctors in other specialties are afraid of pregnant patients, so misinformation abounds,” says Nicole Bullock, DO, FACOOG, an Ob/Gyn and adjunct clinical assistant professor for the University of North Texas’ health science center. She’s heard from patients that health clinics and urgent care centers turned them away from getting a flu shot because they were pregnant.

“Pregnancy does have its own rules, but most of the time things are okay,” Dr. Bullock says. “Number 1: The flu vaccine is definitely recommended.” She often sees people who are on the fence about getting the vaccine because they’re worried it might harm the developing baby, or just because they’d never bothered to get the shot before. Usually, Dr. Bullock only has to explain one fact to get patients on-board with the pregnancy flu shot: It’ll protect your baby, too. “The flu vaccine crosses placenta and breast milk,” she says. “So the benefit is that baby also gets that immunity if mom gets the vaccine. And they’ll do almost anything for baby.”

The only thing she’d caution against is getting the nasal-spray version of the vaccine, because that version uses a live virus and is therefore more likely to cause flu-like symptoms than the shot, which uses a dead virus. Of course, it’s important to note that even the live-virus vaccine won’t give you the actual flu (that’s an urban myth), but pregnant people do have compromised immune systems and so it’s best to avoid any possibility of getting sick. “Your body is busy making a human, so it shuts down in other areas,” Dr. Bullock says. “You’re at higher risk for getting the flu and if you do get the flu it can be really bad.”

Getting the flu while you’re pregnant not only puts you at risk, but can also impact the fetus. “Spontaneous miscarriage, preterm delivery, low birth weight, and even fetal death” are all risks that increase when a pregnant person has the flu, says Hannah Miller, M.D., a family medicine physician at Mayo Clinic Health System in Wisconsin. So it’s important to go to the doctor at the first sign of a possible flu, even if you’re not sure that it’s actually the flu. “It can be tough to determine if you are struggling with a head cold, or if your runny nose is the beginning of the flu,” Dr. Miller says. The influenza virus has familiar symptoms: fever, chills, decreased appetite, headache, runny nose, cough, sore throat, shortness of breath, joint and body pain, and fatigue.

While a runny nose and fever might seem like no big deal, it’s best to be safe and check in with your doctor at the first possible sign (plus, most over the counter cold meds are off-limits in pregnancy, so you’ll need a doctor to point you toward treatments that are safe). They’ll likely prescribe you antiviral medications like Tamiflu or Zanamivir, which can shorten the severity and duration of the flu, and which have been okayed in pregnancy according to the FDA and the Centers for Disease Control and Prevention (CDC).

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Dr. Bullock even recommends patients start taking antiviral drugs if they've simply been exposed to the flu through sick family members or friends (i.e. before symptoms even appear). “Everyone thinks they’re not going to get the flu,” she says. “But pregnancy is a really special time, and anything you can do to lower your risk is a good choice.” One more time to make it super clear: You are at an increased risk of catching the flu while pregnant, and it is a great idea to get vaccinated during pregnancy. Got that parents-to-be?

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