The flu shot is recommended by the United States Centers for Disease Control and Prevention (CDC) for every person over six months of age((https://www.cdc.gov/flu/protect/keyfacts.htm)).   Specifically, the CDC identifies the following populations at greater risk of flu-related complications and stresses vaccinations:

• Children younger than 5, but especially children younger than 2 years old
• Adults 65 years of age and older
• Pregnant women (and women up to two weeks postpartum)
• Residents of nursing homes and other long-term care facilities
• Also, American Indians and Alaskan Natives[1.1 MB, 2 pages] seem to be at higher risk of flu complications((https://www.cdc.gov/flu/about/disease/high_risk.htm))

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1st Trimester Flu Vaccination and Autism  

Published in the current issue of JAMA Pediatrics, the original investigation titled “Association Between Influenza Infection and Vaccination During Pregnancy and Risk of Autism Spectrum Disorder” studied “196,929 children, influenza was diagnosed in 1400 (0.7%) mothers and 45,231 (23%) received an influenza vaccination during pregnancy”.  Researchers found there was no relation between influenza infection and autism; however, they did find an association between first trimester influenza vaccination and autism.  They are careful to say these findings could be a result of “chance” and do not warrant any changes in policy.

Conclusions and Relevance  There was no association between maternal influenza infection anytime during pregnancy and increased ASD risk. There was a suggestion of increased ASD risk among children whose mothers received an influenza vaccination in their first trimester, but the association was not statistically significant after adjusting for multiple comparisons, indicating that the finding could be due to chance. These findings do not call for changes in vaccine policy or practice, but do suggest the need for additional studies on maternal influenza vaccination and autism.((http://jamanetwork.com/journals/jamapediatrics/article-abstract/2587559))

Some scientists are questioning the statistical adjustments made by the researchers in the JAMA Pediatrics study.  

 Robert F. Kennedy, Jr. and  Lyn Redwood, RN, MSN write:

While the researchers found no increased risk when the mother received flu shots in the second or third trimester, the data demonstrated a 20 percent higher risk of an autism spectrum disorder among children of mothers receiving the flu vaccine during the first trimester. That risk was statistically significant. (The P value, .01, indicates a 99 percent likelihood that the result isn’t due to chance.)

However, after completing this analysis, the authors made a series of adjustments that have drawn criticism from other scientists. Most controversial was their questionable decision to apply a statistical device called the “Bonferroni Correction” to their data. Statisticians use the Bonferroni Correction in very specific circumstances—where they seek to reduce the chance for false positives in calculations involving multiple comparisons. The impact of the Bonferroni Correction is nearly always conservative; it dampens signals in data sets. In doing so it creates the risk of missing true associations. When applied to the first trimester flu vaccine dataset, the Bonferroni Correction reduced the significance of the association from 99 percent to 90 percent. Despite the fact that the adjusted result was still considered marginally statistically significant, the authors then made a second dodgy judgment, by declaring that, “this association could be due to chance.”…

Sander Greenland, professor of Statistics and Epidemiology at UCLA’s School of Public Health and College of Letters and Science, agreed that the use of the Bonferroni Adjustment was inappropriate in this context. Greenland is among America’s preeminent statisticians with more than 300 peer reviewed publications—two of which have been cited more than 500 times. He is editor of the Dictionary of Epidemiology. 

Greenland said the research team’s use of Bonferroni makes no sense “where there are finely correlated outcomes” and where the cost of a false negative is high—the possibly erroneous conclusion that first trimester flu shots are safe. ((http://www.ecowatch.com/pregnancy-flu-shot-autism-kennedy-2159830326.html?utm_source=EcoWatch+List&utm_campaign=9144176564-MailChimp+Email+Blast&utm_medium=email&utm_term=0_49c7d43dc9-9144176564-85357185))

Flu complications in pregnancy

Although there is no increased risk of autism from having the flu, there are many complications and risks to getting sick while pregnant.  Premature labor  and birth defects are of biggest concern, hence the CDC recommendations.((https://www.cdc.gov/flu/protect/vaccine/pregnant.htm))

Waiting until the second or third trimester to get a flu vaccine may seem prudent; however, many of the complications occur during the first trimester, like congenital heart defects.  During the fifth week of gestation major organs begin to form like the brain, spinal cord, and heart.((http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-care/art-20045302))

Benefits of the flu shot in pregnancy  

One study conducted in Australia found that the pregnancy flu shots reduced stillbirths:

After adjusting for maternal age, socioeconomic status, diabetes, hypertension and other health and behavioral characteristics, they found that the risk of stillbirth was 51 percent lower in vaccinated women than in unvaccinated ones.((http://well.blogs.nytimes.com/2016/04/07/flu-shot-during-pregnancy-may-reduce-risk-of-stillbirths/?_r=0))

Another study found pregnancy flu shots provide protection to newborns for up to six months following birth.  Newborn babies are amongst the CDC identified at-risk population from influenza.  Forbes magazine reports:

Babies can’t get the flu vaccine until they turn 6 months old—even though children and infants die every year from the flu. But that doesn’t meant moms can’t offer their infants some protection against the flu until children are old enough to be immunized themselves, as a new study shows. In fact, babies whose mothers got the seasonal flu vaccine during pregnancy were 70% less likely to contract the flu than babies born to unimmunized mothers, thanks to two protective mechanisms working together.

“Immunizing pregnant women provides immunity to the baby through the placenta,” explained lead author Julie H. Shakib, DO, assistant professor of pediatrics at the University of Utah in Salt Lake City and medical director of the Well Baby and Intermediate Nursery. “Immunizing the mother and others who live with or care for the baby prevents them from getting the flu and passing it to the baby”—a concept known as cocooning.((http://www.forbes.com/sites/tarahaelle/2016/05/03/a-flu-shot-during-pregnancy-protects-babies-from-flu-up-to-6-months-later/#47520f70510b))

Preventing the above-mentioned complications is the greatest potential benefit of the flu shot, but there is no guarantee researchers will pick the correct strain for vaccine development.

Breastfeeding offers better protection than the flu shot

It is important to note that breastfeeding provides better flu protection than a shot by passing the mother’s antibodies onto the baby.  The La Leche League International explains:

One way breast feeding protects your newborn from illnesses is the immune molecules, called antibodies, that are present in breast milk. Antibodies are made by your body’s immune system and are very specific molecules that help you fight each illness. When babies are born, their immune systems are very immature and they have less ability to fight illness-causing germs. Through your breast milk, you give your baby immunities to illnesses to which you are immune and also those to which you have been exposed. Nursing also allows your baby to give germs to you so that your immune system can respond and can synthesize antibodies! This means that if your baby has come in contact with something which you have not, (s)he will pass these germs to you at the next nursing; during that feeding, your body will start to manufacture antibodies for that particular germ. By the time the next feeding arrives, your entire immune system will be working to provide immunities for you and your baby. If you are exposed to any bacteria or viruses, your body will be making antibodies against them and these will be in your milk. Breast milk also contains a host of other immune molecules that also help protect your baby from germs. It’s an awesome system!((http://www.llli.org/faq/prevention.html))

This protection is superior to flu vaccinations as it adapts to any new germs and viruses present, not just those covered by the current season’s flu vaccine. 

Flu vaccine controversy and risks

Each year the flu vaccine is developed based on the best guess as to which strains will be dominant.  Some years vaccine developers get it rights; some years they do not. The CDC explains:

The seasonal influenza (flu) vaccine is designed to protect against the three or four influenza viruses research indicates are most likely to spread and cause illness among people during the upcoming flu season. Flu viruses are constantly changing, so the vaccine composition is reviewed each year and updated as needed based on which influenza viruses are making people sick, the extent to which those viruses are spreading, and how well the previous season’s vaccine protects against those viruses.((https://www.cdc.gov/flu/about/season/vaccine-selection.htm))

Just because you get the flu vaccine, there is no guarantee you will not get sick.  Many people often report getting sick after getting the vaccine.((http://www.miamiherald.com/news/nation-world/national/article50769245.html)) You could also get sick from one of the strains not included in the current vaccine.

The flu vaccine contains mercury. This is the same ingredient that has been removed from childhood vaccines, but it still remains as a preservative in the seasonal influenza shot. ((https://www.pregnancymagazine.com/pregnancy/is-the-flu-shot-safe-during-pregnancy)) Pregnant women are advised to avoid consuming fish containing mercury.  According to Fit Pregnancy, mercury has been linked to “impaired language, memory, cognitive thinking and fine-motor and visual-spatial skills among children who were exposed to it in utero”.((http://www.fitpregnancy.com/nutrition/prenatal-nutrition/mercury-rising-0)) Although the thimerosal in the flu vaccine is a trace amount, one must consider the cumulative effect of all mercury exposure while pregnant. 

Dr. Kelly Brogan further explains the risks:

• Multiexposure

  The flu vaccine is prepared with egg proteins and associated unidentified viral DNA from this animal tissue, the allergen gelatin, polysorbate 80 which crosses the blood brain barrier, the carcinogen formaldehyde, the detergent triton x100, sucrose, resin, the antibiotic gentamycin, and thimerosol/mercury. Double talk of mercury exposure in pregnancy (don’t eat sushi, get your vaccine!) is only one glaringly egregious example of the CDC’s selective neglect of peer-reviewed published literature demonstrating profound harm associated with this neurotoxic metal.Mercury-containing vaccines are offered to pregnant women despite evidence as recent as last month which linked vaccine-related exposure to autism spectrum disorders. The unstudied role of these ingredients is compounded by the genome-altering effects of unquantified viral DNA from the cross-species preparation of this product. Multiple exposures through different vaccine preparations have never been studied, despite accumulating evidence of synergistic toxicity, mortality, and risk associated with other pregnancy-related vaccines such as DTaP.

• Inflammation

  Perhaps the most concerning study I have come across implicated the influenza vaccination in a strong inflammatory response in pregnant woman. Here, the investigators identified significantly elevated CRP two days after vaccination and a similar (but non-significant) pattern for TNF-alpha. They address the notion of vulnerable subgroups as being more important than generalizable findings. For example, the most depressed women at the time of vaccination exhibited an increased inflammatory response to vaccination – suggestive of inflammatory priming by the depressed state or an impairment of the inflammatory attenuation that is typical of a pregnant state. Stating that this inflammation is preferable to that of a flu virus infection is hand waving assumption, and is guaranteeing an inflammatory response in a woman who may very well have been otherwise unaffected.((http://kellybroganmd.com/rejecting-flu-vaccine-in-pregnancy/))

Just like breastfeeding provides better protection for babies as their immune systems are developing, some doctors recommend vitamin D is more effective than the flu vaccine. It is recommended that pregnant women get 4,000 IU of vitamin D daily, yet most prenatal vitamins only contain 400 IU.((http://americanpregnancy.org/pregnancy-health/vitamin-d-and-pregnancy/))

Furthermore, researchers have found that good hygiene is more effective than the flu vaccine.((https://healthimpactnews.com/2012/study-shows-soap-may-be-more-effective-than-vaccines/))

Some doctors have called into question the marketing of the flu vaccine. According to Dr. Doshi:

THE VACCINE MIGHT BE LESS BENEFICIAL AND LESS SAFE THAN HAS BEEN CLAIMED, AND THE THREAT OF INFLUENZA APPEARS OVERSTATED.

Doshi asserts that influenza is a case of “disease mongering” in an effort to expand markets. He points to the fact that deaths from flu declined sharply during the middle of the 20th century, long before the huge vaccine campaigns that kicked off the 21st century.

 

Why do drug companies push the flu vaccine? “It’s all about money,” says Dr. Blaylock. “Vaccines are a pharmaceutical company’s dream. They have a product that both the government and the media will help them sell, and since vaccines are protected, they can’t be sued if anyone has a complication.”((http://eyr.lil.mybluehost.me/2014/09/07/vaccine-debate-marketing-the-flu-shot/))

When making decisions about whether or not to get the flu vaccine while pregnant, it is important to be informed and discuss the information with your midwife and/or doctor.  There are different risk factors, such as exposure if you work in a school or have other children, that your pregnancy care provider can help you assess.  Natural alternatives exist that may be more effective than seasonal vaccinations.