Flu and Seasonal Influenza Vaccine

Section 1.1

Midwives may independently prescribe, order and administer this drug.

The inactivated influenza vaccines protect against seasonal influenza. These are reformulated annually because the circulating influenza viruses change. Included are standardized amounts of the Hemagglutinin (HA) protein from representative seed strains of the two human influenza A subtypes (H3N2 and H1N1) and one or two of the two influenza B lineages.

Indications and Clinical Use:

Inactivated influenza vaccine is recommended for all pregnant individuals, regardless of trimester, during the influenza season because of their increased risk of influenza-associated morbidity, evidence of adverse neonatal outcomes associated with maternal influenza, evidence that vaccination of pregnant women protects their newborns from influenza and influenza-related hospitalization, and evidence that infants born during the influenza season to vaccinated women are less likely to be premature, small for gestational age, and low birth weight. Immunization during pregnancy has the advantage of protecting the fetus through transplacental antibody passage or through breast milk.


History of anaphylaxis to a previous dose of any type of influenza vaccine or any component of the vaccine; history of Guillain-Barré syndrome within eight weeks of receipt of a previous dose of influenza vaccine without another cause being identified.

Warnings and Precautions:

Epinephrine (1:1000) and Diphenhydramine hydrochloride should be available for immediate use in the event of an anaphylactic reaction.


Compatible – inactivated influenza vaccines can be administered at any stage of pregnancy


Category L1 – Limited Data – Compatible

Adverse Reactions:

Possible reactions are usually mild and temporary and may include tenderness, redness, itching, bruising, and muscle ache at the injection site; and /or headache, fatigue, fever and myalgia.

Dosage and Administration:

 IM: 0.5 mL of inactivated influenza vaccine. The deltoid muscle is the recommended site in adults.