Flu Vaccination - Women

Flu Vaccination - Women in United States

United States

The flu vaccine helps protect people against seasonal influenza (flu) viruses that may lead to severe complications. The Centers for Disease Control and Prevention (CDC) estimates that during the 2019-2020 flu season, vaccines prevented 7.5 million illnesses and over 105,000 hospitalizations associated with influenza. 

While all women are at risk of complications from influenza (including bacterial pneumonia, bronchitis and sinus and ear infections), pregnant women are at greater risk of severe illness, hospitalization and even death from the flu. Influenza-related complications among pregnant women can lead to an increased risk of preterm delivery, low birthweight infants and other complications. Among pregnant women, the flu shot reduced the risk of being hospitalized with the flu by an average of 40% during 2010-2016. Getting the flu vaccine while pregnant also helps protect babies from flu illness in the first several months after their birth, when they are too young to get vaccinated. 

The annual economic impact of influenza on the United States in 2015 was approximately $11.2 billion. A 2019 study found the cost effectiveness of flu vaccinations among adults ages 18-64 was between $8,000 and $39,000 per quality-adjusted life-year (QALY) saved. The same study found that the cost effectiveness of vaccinating pregnant women ranged between $85,000 and $260,000 per QALY saved depending on the severity of the flu season. Flu vaccination is highly cost-effective among pregnant women.

Flu vaccine coverage is higher among:

• Women ages 35-44 compared with women ages 18-34. 
• Non-Hispanic Asian women compared with non-Hispanic Black women. 
• College graduates compared with women who have less than a high school education. 
• Women with an annual household income of $75,000 or more compared with those with an income less than $25,000. 
• Women living in metropolitan areas compared with those in non-metropolitan areas.

Strategies to increase flu vaccination among women include:

• Encouraging health care providers to discuss flu vaccination with patients. Negative views of the flu vaccine are a major reason for not getting vaccinated, particularly among pregnant women. Patients are more likely to get vaccinated when providers recommend, offer and discuss flu vaccination with them. 
• Providing client reminders for patients who have previously received vaccination. 
• Providing free or reduced-cost vaccinations. Most insurance plans cover the flu vaccine. However, for those without health insurance, removing cost as a barrier can increase vaccination rates.
• Increasing awareness through campaigns. The CDC provides seasonal flu vaccination campaign materials to assist partners in communicating the importance of vaccination. 

The American College of Obstetricians and Gynecologists strongly recommends pregnant women, or those expecting to be pregnant during flu season, get vaccinated to protect their own health and the health of their child. Find a flu clinic near you using the CDC’s Flu Vaccine Finder tool. For more resources and information on the flu and flu prevention strategies, visit flu.gov.

Healthy People 2030’s flu vaccination goal is to increase the proportion of people who get the annual flu vaccine.

ACOG Immunization, Infectious Disease, and Public Health Preparedness Expert Work Group, Kevin A. Ault, and Laura E. Riley. 2018. “ACOG Committee Opinion No. 741: Maternal Immunization.” Obstetrics & Gynecology 131 (6): e214–17. https://doi.org/10.1097/AOG.0000000000002662.

Chaiken, Sarina R., Alyssa R. Hersh, Marguerite S. Zimmermann, Britta M. Ameel, Vanessa R. Layoun, and Aaron B. Caughey. 2021. “Cost-Effectiveness of Influenza Vaccination during Pregnancy.” The Journal of Maternal-Fetal & Neonatal Medicine, January. https://doi.org/10.1080/14767058.2021.1876654.

Dabestani, Nazila M., Andrew J. Leidner, Eric E. Seiber, Hyoshin Kim, Samuel B. Graitcer, Ivo M. Foppa, and Carolyn B. Bridges. 2019. “A Review of the Cost-Effectiveness of Adult Influenza Vaccination and Other Preventive Services.” Preventive Medicine 126 (September): 105734. https://doi.org/10.1016/j.ypmed.2019.05.022.

Henninger, Michelle L., Stephanie A. Irving, Mark Thompson, Lyndsay Ammon Avalos, Sarah W. Ball, Pat Shifflett, Allison L. Naleway, and on behalf of the Pregnancy and Influenza Project (PIP) Working Group. 2015. “Factors Associated with Seasonal Influenza Vaccination in Pregnant Women.” Journal of Women’s Health 24 (5): 394–402. https://doi.org/10.1089/jwh.2014.5105.

Putri, Wayan C. W. S., David J. Muscatello, Melissa S. Stockwell, and Anthony T. Newall. 2018. “Economic Burden of Seasonal Influenza in the United States.” Vaccine 36 (27): 3960–66. https://doi.org/10.1016/j.vaccine.2018.05.057.

Rasmussen, Sonja A., Denise J. Jamieson, and Timothy M. Uyeki. 2012. “Effects of Influenza on Pregnant Women and Infants.” American Journal of Obstetrics and Gynecology 207 (3): S3–8. https://doi.org/10.1016/j.ajog.2012.06.068.

Thompson, Mark G., Jeffrey C. Kwong, Annette K. Regan, Mark A. Katz, Steven J. Drews, Eduardo Azziz-Baumgartner, Nicola P. Klein, et al. 2019. “Influenza Vaccine Effectiveness in Preventing Influenza-Associated Hospitalizations During Pregnancy: A Multi-Country Retrospective Test Negative Design Study, 2010–2016.” Clinical Infectious Diseases 68 (9): 1444–53. https://doi.org/10.1093/cid/ciy737.