Today's Medicine

Protecting Yourself and Baby When Pregnancy Coincides With Flu Season (and a Pandemic)

Published: Sept. 14, 2020

So much is still unknown about COVID-19 and pregnancy, especially when it comes to how the virus affects the unborn child.

If we’ve learned anything about this pandemic, it’s that science cannot be rushed. It can take years of research to get answers to critical questions surrounding a new virus. But there is a virus that has decades of research behind it, including its effects on pregnancy: influenza.

The flu vaccine is your best defense

Influenza has long been known as a high-risk virus for pregnant women, who are more susceptible to experiencing flu-related hospitalizations and acute respiratory disease. As if the gravity of that isn’t enough, the virus can also be deadly. During the 2009-2010 H1N1 pandemic, 5% of all deaths related to H1N1 were pregnant women – a group that makes up 1% of the population. But this has been true of past pandemics as well (1918 and 1957): There were higher mortality rates among pregnant women.

The silver lining? Vaccines. They’re one the greatest public health advancements and are particularly important for high-risk populations, including pregnant women. The Centers for Disease Control and Prevention, American College of Obstetricians and Gynecologists and the World Health Organization agree: Pregnant women – no matter their gestational age – should receive the flu shot as soon as it’s available in the fall.

It's not only safe, it's effective

While vaccination may not be able to prevent all strains of the flu virus, the most common and likely strains for the season will be covered by the vaccine. And if you do get sick with influenza, the vaccine has been shown to reduce the risk of acute respiratory disease by up to 50%. It’s also been shown to reduce a pregnant woman’s risk for flu-related hospitalization by 40%.

Aside from serving as an important prevention strategy for mothers, the vaccine protects infants, too. Remember, infants cannot be immunized until they are 6 months old. And studies have shown that when pregnant women receive the influenza vaccine, it protects infants from influenza for four to six months after birth. The vaccine also decreases the risk of febrile respiratory illness by one-third. So, science shown us that the vaccine is not only safe but also effective – for mother and baby.

All that said, infants younger than 6 months aren’t the only ones who should avoid the vaccine. Other groups include those with:

  • Life-threatening allergies to the flu vaccine or ingredients
  • Severe egg allergies
  • A history of Guillain-Barré syndrome

If you’re unsure whether the flu vaccine is right for you, it’s best to contact your provider.

Symptoms may easily be confused for those of COVID-19

Similar to coronavirus, influenza spreads through respiratory droplets in the air and on surfaces. And there’s a lot of overlap between symptoms of COVID-19 and influenza, which makes flu season during a pandemic all the more confusing. The most common symptoms of influenza include:

  • Body aches
  • Cough
  • Fatigue
  • Fever and/or chills
  • Headache
  • Shortness of breath
  • Sore throat

Some people also experience vomiting or diarrhea, but these symptoms are less common. One of the major symptoms of COVID-19 that hasn’t been seen with the flu is change in or loss of taste and smell.

If you have any of the above symptoms, contact your health care provider immediately. You may be urged to be tested for influenza, COVID-19 or both.

Important: If you have severe symptoms – like shortness of breath, chest pain, seizures, severe weakness, decreased baby movement or a fever that doesn’t respond to medication like acetaminophen – call 911 immediately.

If you do get sick, rest easy


Depending on where you’re at in your illness, a positive influenza test might warrant a prescription for oseltamivir (Tamiflu®), an anti-viral medication that’s been well studied in pregnancy. It can be extremely effective in shortening the duration and severity of your illness if treatment begins within 48 hours of symptom onset.

Prescription or not, your provider will likely recommend supportive care and urge you to:

  • Stay hydrated
  • Keep up on fever-reducing medication
  • REST

Effects on mom and baby

Again, pregnant women are more likely than the general public to become severely ill as a result of influenza, which makes taking the proper precautions all the more critical. COVID-19 likely has you taking a lot of important steps already. You’ll be doing all the right things if you take advantage of the flu shot when it’s available, if you continue masking and if you:

  • Avoid those who are sick
  • Avoid touching your eyes, nose and mouth
  • Disinfect high-touch areas
  • Wash your hands frequently

If you do get influenza while pregnant, the good news is: Most women do very well and can remain out of the hospital. If you do need to be hospitalized, know that it’s because you simply require more supportive care for you and baby, who will likely be just fine. There’s no evidence that the influenza virus crosses the placenta and is transmitted to the fetus.

So, rest easy. Once your illness has resolved, you and your pregnancy are not at additional risk of complications. You’re free to resume decorating that nursery and planning all things associated with that tiny miracle growing inside you.

This year’s vaccine is now readily available at local pharmacies and from your Methodist Physicians Clinic primary care provider. Methodist Physicians Clinic is also offering drive-thru flu shots by appointment at five area locations.

More Resources

About the Author

As a maternal-fetal medicine specialist, Emily Patel, MD, FACOG, is most inspired by the women and families she cares for. She has seen and experienced the gamut of her specialty, including the joy of bringing a rainbow baby into the world and the heart-wrenching loss of a newborn or stillborn baby.

“Having the chance to help a family through a difficult and challenging pregnancy is a privilege,” she said. “While there are many difficult days, there are also times I get to celebrate a good pregnancy outcome, and that gives me so much joy!”

She attended medical school and completed her residency at the University of Nebraska Medical Center. She also completed a fellowship in maternal-fetal medicine at Duke University. 

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