H1N1 Flu

Vaccination for H1N1 for 2009 H1N1 influenza virus and for seasonal influenza is recommended by many organizations, including CDC and ACOG. If vaccination in your office is not feasible, you should instruct them where they can go to be vaccinated. Document these conversations and your patients' vaccination status. The Centers for Disease Control and Prevention (CDC) has posted information that addresses 2009 H1N1 influenza vaccine in pregnancy with Qs and As for women and clinicians at http://www.cdc.gov/h1n1flu/pregnancy/. See also http://www.acog.org/departments/resourceCenter/2009H1N1TriageTreatment.p... and http://www.acog.org/departments/resourceCenter/2009H1N1FactSheet.pdf

State pre-registration is key for physicians administering H1N1 vaccine. In anticipation of the availability of the H1N1 vaccine, many states have established a pre-registration process that will allow physicians and health care providers who are authorized to administer vaccinations to pre-register for receipt of the H1N1 vaccine. Visit http://www.cdc.gov/h1n1flu/vaccination/statecontacts.htm for state/jurisdiction contact information for providers interested in supplying the H1N1 vaccine. If your state contact information is not yet listed, contact your local health department. CDC is updating the list as states develop their plans.

To get help with your immunization plans and to be aware of your community's plan, contact your local health department or state/jurisdiction public health contact at http://www.cdc.gov/h1n1flu/vaccination/statecontacts.htm. If your state contact information is not yet listed, contact your local health department.
Updated antiviral information
Since rapid access to antiviral medications is essential, health care providers who care for pregnant women should develop methods to ensure that treatment can be started quickly after symptom onset. More information regarding antiviral treatment can be found on the CDC website at http://www.cdc.gov/H1N1flu/pregnancy/antiviral_messages.htm. Actions that will support initiation of early treatment include:
- Informing pregnant women of signs and symptoms of influenza and need for early treatment after onset of symptoms of influenza.
- Ensuring rapid access to telephone consultation and clinical evaluation for these patients as well as patients who report severe illness.
- Considering empiric treatment of pregnant women based on telephone contact if hospitalization is not indicated and if this will substantially reduce delay before treatment is initiated.
In selected circumstances, providers might also choose to provide pregnant women with prescriptions that can be filled at the onset of symptoms after telephone consultation with the provider. This strategy could substantially reduce delay before treatment in pregnant patients with comorbidities.