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<div class=Section1>
<p class=MsoNormal><b><font size=2 face=Tahoma><span lang=EN-US
style='font-size:10.0pt;font-family:Tahoma;font-weight:bold'>From:</span></font></b><font
size=2 face=Tahoma><span lang=EN-US style='font-size:10.0pt;font-family:Tahoma'>
Malcolm McDonald <br>
<b><span style='font-weight:bold'>Sent:</span></b> Thursday, October 02, 2008
1:05 PM<br>
<b><span style='font-weight:bold'>To:</span></b> '<st1:PersonName w:st="on">carpa@ozdocit.org</st1:PersonName>'<br>
<b><span style='font-weight:bold'>Subject:</span></b> Influenza vaccination in
pregnancy </span></font><span lang=EN-US><o:p></o:p></span></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-US
style='font-size:12.0pt'><o:p> </o:p></span></font></p>
<ol style='margin-top:0cm' start=1 type=1>
<li class=MsoNormal style='line-height:150%;mso-list:l3 level1 lfo5'><font
size=2 face=Arial><span style='font-size:10.0pt;line-height:150%;
font-family:Arial'>Influenza has an increased morbidity and mortality in
pregnancy. <o:p></o:p></span></font></li>
<li class=MsoNormal style='line-height:150%;mso-list:l3 level1 lfo5'><font
size=2 face=Arial><span style='font-size:10.0pt;line-height:150%;
font-family:Arial'>Influenza has an increased morbidity and mortality in
the first year of life. <o:p></o:p></span></font></li>
<li class=MsoNormal style='line-height:150%;mso-list:l3 level1 lfo5'><font
size=2 face=Arial><span style='font-size:10.0pt;line-height:150%;
font-family:Arial'>Inactivated influenza vaccination is safe in pregnancy.
<o:p></o:p></span></font></li>
<li class=MsoNormal style='line-height:150%;mso-list:l3 level1 lfo5'><font
size=2 face=Arial><span style='font-size:10.0pt;line-height:150%;
font-family:Arial'>Inactivated influenza vaccination is currently
recommended in pregnancy (The Australian Immunisation Handbook) to protect
the mother. <o:p></o:p></span></font></li>
<li class=MsoNormal style='line-height:150%;mso-list:l3 level1 lfo5'><font
size=2 face=Arial><span style='font-size:10.0pt;line-height:150%;
font-family:Arial'>In a recently published study in a setting with
year-round influenza (similar to the NT), inactivated influenza vaccine
given in pregnancy substantially reduced proven influenza in infants <
6 months of age and averted a third of all febrile respiratory
illness in mothers and young infants. <o:p></o:p></span></font></li>
<li class=MsoNormal style='line-height:150%;mso-list:l3 level1 lfo5'><font
size=2 face=Arial><span style='font-size:10.0pt;line-height:150%;
font-family:Arial'>We recommended that health practitioners include
inactivated influenza vaccination for pregnant women as part of routine
antenatal care. <o:p></o:p></span></font></li>
</ol>
<p class=MsoNormal style='line-height:150%'><font size=2 face=Arial><span
style='font-size:10.0pt;line-height:150%;font-family:Arial'><o:p> </o:p></span></font></p>
<p class=MsoNormal style='line-height:150%'><font size=2 face=Arial><span
style='font-size:10.0pt;line-height:150%;font-family:Arial'>References <o:p></o:p></span></font></p>
<ol style='margin-top:0cm' start=1 type=1>
<ul style='margin-top:0cm' type=disc>
<li class=MsoNormal style='line-height:150%;mso-list:l2 level2 lfo8'><font
size=2 face=Arial><span style='font-size:10.0pt;line-height:150%;
font-family:Arial'>The Australian Immunisation Handbook 9<sup>th</sup>
Edition 2008<o:p></o:p></span></font></li>
<li class=MsoNormal style='line-height:150%;mso-list:l2 level2 lfo8'><font
size=2 face=Arial><span style='font-size:10.0pt;line-height:150%;
font-family:Arial'>Rothberg et al. Complications of viral influenza. Am J
Med 2008; 21:258-64<o:p></o:p></span></font></li>
<li class=MsoNormal style='line-height:150%;mso-list:l2 level2 lfo8'><font
size=2 face=Arial><span style='font-size:10.0pt;line-height:150%;
font-family:Arial'>Zaman K, et al. Effectiveness of maternal influenza
immunization in mothers and infants. N Engl J Med 2008 (ePublished -
PMID: 18799552)<o:p></o:p></span></font></li>
</ul>
</ol>
<p class=MsoNormal style='line-height:150%'><font size=2 face=Arial><span
style='font-size:10.0pt;line-height:150%;font-family:Arial'><o:p> </o:p></span></font></p>
<p class=MsoNormal style='line-height:150%'><font size=2 face=Arial><span
style='font-size:10.0pt;line-height:150%;font-family:Arial'>Dr Malcolm McDonald
– Specialist Outreach Physician, <st1:place w:st="on"><st1:PlaceName
w:st="on">Menzies</st1:PlaceName> <st1:PlaceType w:st="on">School</st1:PlaceType></st1:place>
of Health Research <o:p></o:p></span></font></p>
<p class=MsoNormal style='line-height:150%'><font size=2 face=Arial><span
style='font-size:10.0pt;line-height:150%;font-family:Arial'>Prof Anne Chang
– Head, Division of Child Health, <st1:place w:st="on"><st1:PlaceName
w:st="on">Menzies</st1:PlaceName> <st1:PlaceType w:st="on">School</st1:PlaceType></st1:place>
of Health Research <o:p></o:p></span></font></p>
<p class=MsoNormal style='line-height:150%'><font size=2 face=Arial><span
style='font-size:10.0pt;line-height:150%;font-family:Arial'>Dr Vicki Krause
– Director, Centre f<font color=navy><span style='color:navy'>or</span></font>
Disease Control, DHF (NT) <font color=navy><span style='color:navy'><o:p></o:p></span></font></span></font></p>
<p class=MsoNormal style='line-height:150%'><font size=2 color=navy face=Arial><span
style='font-size:10.0pt;line-height:150%;font-family:Arial;color:navy'>Dr Ros
Webby – Head of Immunisation, </span></font><font size=2 face=Arial><span
style='font-size:10.0pt;line-height:150%;font-family:Arial'>Centre f<font
color=navy><span style='color:navy'>or</span></font> Disease Control, DHF (NT) <font
color=navy><span style='color:navy'><o:p></o:p></span></font></span></font></p>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>Ms Chris Nagy – Immunisation Project Officer, Centre f<font
color=navy><span style='color:navy'>or</span></font> Disease Control, DHF (NT)
</span></font><font size=2 color=navy face=Arial><span lang=EN-US
style='font-size:10.0pt;font-family:Arial;color:navy'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span lang=EN-US
style='font-size:10.0pt;font-family:Arial;color:navy'><o:p> </o:p></span></font></p>
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