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Personal Health Jane Brody on health and aging.

On Dec. 20, 1968, I was in Minnesota for a family wedding and got the flu; what I didn’t get, to my surprise, was my period. With a fever of 104 degrees, I was too sick to eat or even go to the bathroom unaided for 10 days. Returning to New York on Sunday night of New Year’s weekend, I was struggling to breathe and too weak to walk.

My husband carried me down the block to the home office of a doctor, who quickly diagnosed double pneumonia and prescribed antibiotics and codeine cough medicine. The pneumonia resolved but was followed by two more respiratory infections that required further treatment.

I was three months pregnant before I finally felt well. Six months later, I gave birth to miraculously healthy, full-term identical twins. I had dodged a bullet.

But not every pregnant woman who develops the flu — or some other vaccine-preventable infection — is so lucky. The flu is one of a number of infections, especially those accompanied by a high fever, that can cause serious pregnancy complications, including miscarriage, birth defects, premature delivery and even death.

If this sounds scary, it’s meant to be. Too many women go through pregnancy unprotected by readily available vaccines that can prevent irreversible harm to the woman, her unborn child or infant before the baby is old enough to be immunized directly.

Most women now of childbearing age are too young to have witnessed the harm associated with these infections before there were vaccines to prevent them that could be administered before or during pregnancy. Far too many have succumbed to fear-mongering by people who wrongly believe vaccines do more harm than good.

Experts are especially alarmed by the fact that, unlike with other aspects of medical care, highly educated people are most likely to resist vaccination.

“The rise in nonimmunization of children is clustered in high-income areas,” Dr. Mark H. Sawyer, a pediatrician and infectious disease specialist at the University of California, San Diego, said at a recent meeting held by the March of Dimes to emphasize the importance of pregnancy-related protection.

Dr. Sawyer blamed a lack of scientific literacy for recent outbreaks of vaccine-preventable diseases, which, he said, are now occurring in the hundreds of thousands in countries like Switzerland and France that previously had low rates of such diseases. “Vaccine-preventable diseases are still around, and they will come back,” he said. “It’s very hard to get the genie back in the bottle once an outbreak starts.”

Citing data from the Centers for Disease Control and Prevention, Dr. Sawyer said that from 1994 through 2013, vaccines have prevented about 730,000 deaths, 21 million hospitalizations and 300 million visits to doctors’ offices.

Protecting pregnant women is especially critical, Dr. Sonja Rasmussen, a public health specialist and editor of the Morbidity and Mortality Weekly Report, told the meeting. Getting the measles-mumps-rubella (M.M.R.) vaccine before pregnancy and the flu shot and tetanus-diphtheria-pertussis (TDAP) vaccine during pregnancy “is a two-for-one benefit that protects both mothers and their babies,” she said.

Babies are protected for months after birth by antibodies formed in pregnant women who are immunized. Babies younger than a year are most at risk of developing pertussis, or whooping cough. In Wisconsin alone in 2012, 367 babies less than a year old came down with whooping cough, 60 of whom had to be hospitalized and three of whom died. The pertussis vaccine is given at 2 months, 4 months and 6 months of age, which makes protection from mothers’ antibodies essential in the first half-year of life.

“For a child to die from whooping cough in this day and age is criminal,” said Dr. Thomas N. Saari, a professor of pediatrics at the University of Wisconsin Medical School in Madison.

Women should get the TDAP vaccine during the third trimester of every pregnancy, from Weeks 28 to 36, regardless of whether they had it before, but only about 14 percent of women do, Dr. Rasmussen said. All family members and caregivers of infants, including babysitters and grandparents, should also get the TDAP vaccine, the C.D.C. urges. While pregnant women should avoid vaccines made from live viruses, weakened or otherwise, the TDAP vaccine does not contain live viruses.

Pregnant women should likewise get a flu shot, though not the nasal spray flu vaccine, which contains live virus. Dr. Rasmussen explained that changes that occur in a pregnant woman’s immune system, heart and lungs increase the risk of complications, including death, from influenza. Infants less than six months old “are too young to be vaccinated” and face a risk of severe illness or death from the flu, she said, yet are “60 percent less likely to get the flu” if their mothers are immunized.

“The flu shot is safe during any trimester of pregnancy, but only about half of pregnant women get immunized against the flu,” Dr. Rasmussen said. “All women who will be pregnant during flu season should get a flu shot. Everyone else in the family should get the shot as well.”

Vaccines made from live viruses, like the M.M.R. for measles, mumps and rubella, and the chickenpox vaccine, should be given a month or more before a woman becomes pregnant. Women contemplating pregnancy should have their immunity against these infections checked with a blood test and, if found deficient, be vaccinated and use birth control for a month before trying to conceive. If a woman contracts rubella (formerly known as German measles) during pregnancy, especially during the first trimester when many women are not even aware they are pregnant, her baby can develop multiple abnormalities, including heart defects, deafness, cataracts and developmental disability.

The C.D.C. recommends that new mothers who were not previously immunized get the TDAP vaccine and vaccines for measles, mumps, rubella and chickenpox after giving birth, before leaving the hospital. These vaccines are safe even for women who are breast-feeding.

Some pregnant women, depending on their jobs or lifestyle, should also consider being immunized against hepatitis B, an infection that can be passed on to babies during delivery and result in a high risk of liver disease as adults. The C.D.C. recommends screening pregnant women for this illness.

Pregnant women planning international travel are urged to talk with their doctors at least four weeks before the trip to discuss precautions or vaccines that may be needed. Depending on the destination, some usually recommended vaccines should be avoided during pregnancy, making it necessary to weigh risks and benefits. More information is available at the C.D.C.’s Travelers’ Health website.

This is the first of two columns on vaccines to protect child health.

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