Flu Vaccination - Women in United States

United States

The flu vaccine helps protect people against seasonal influenza viruses (known as the flu) that may lead to severe complications. Estimates suggest that during the 2022-2023 flu season, vaccines prevented 6 million flu-related illnesses and 65,000 hospitalizations associated with influenza in the United States. 

While all women are at risk of developing complications from influenza (such as pneumonia and sinus and ear infections), pregnant women are at greater risk of severe illness and hospitalization. Influenza-related complications among pregnant women can lead to increased risk of preterm delivery, low birth weight infants and other complications. During 2010-2016, the flu shot reduced the risk of pregnant women being hospitalized with the flu by an average of 40%. 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. 

Flu vaccination is highly cost-effective among pregnant women. In 2015, the annual economic impact of influenza on the U.S. was approximately $11.2 billion.

According to America’s Health Rankings analysis, the prevalence of flu vaccination is higher among:

• Women ages 35-44 compared with women ages 18-34. 
• Non-Hispanic Asian women compared with non-Hispanic American Indian/Alaska Native women. 
• College graduates compared with women with less education. 
• Women with an annual household income of $75,000 or more compared with those who have incomes less than $25,000.
• Women living in metropolitan areas compared with those in nonmetropolitan areas.
• Women living without a disability compared with those who have difficulty seeing.
• LGBQ+ women compared with straight women. 
• Women who have served in the U.S. armed forces compared with women who have not served.

Interventions 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 vaccinations. 
• Providing free or reduced-cost vaccinations.
• Increasing awareness through campaigns. The Centers for Disease Control and Prevention (CDC) provides seasonal flu vaccination campaign materials to help partners communicate the importance of vaccination. 

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

Healthy People 2030 has a goal to increase the proportion of people who get the annual flu vaccine.

Ault, Kevin A., Laura E. Riley, and ACOG Immunization, Infectious Disease, and Public Health Preparedness Expert Work Group. “ACOG Committee Opinion No. 741: Maternal Immunization.” Obstetrics & Gynecology 131, no. 6 (June 2018): 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. “Cost-Effectiveness of Influenza Vaccination during Pregnancy.” The Journal of Maternal-Fetal & Neonatal Medicine, January 21, 2021. https://doi.org/10.1080/14767058.2021.1876654.

Dawood, Fatimah S., Wanitchaya Kittikraisak, Archana Patel, Danielle Rentz Hunt, Piyarat Suntarattiwong, Meredith G. Wesley, Mark G. Thompson, et al. “Incidence of Influenza during Pregnancy and Association with Pregnancy and Perinatal Outcomes in Three Middle-Income Countries: A Multisite Prospective Longitudinal Cohort Study.” The Lancet Infectious Diseases 21, no. 1 (January 2021): 97–106. https://doi.org/10.1016/S1473-3099(20)30592-2.

Henninger, Michelle L., Stephanie A. Irving, Mark Thompson, Lyndsay Ammon Avalos, Sarah W. Ball, Pat Shifflett, and Allison L. Naleway. “Factors Associated With Seasonal Influenza Vaccination in Pregnant Women.” Journal of Women’s Health 24, no. 5 (May 14, 2015): 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. “Economic Burden of Seasonal Influenza in the United States.” Vaccine 36, no. 27 (June 22, 2018): 3960–66. https://doi.org/10.1016/j.vaccine.2018.05.057.

Thompson, Mark G., Jeffrey C. Kwong, Annette K. Regan, Mark A. Katz, Steven J. Drews, Eduardo Azziz-Baumgartner, Nicola P. Klein, et al. “Influenza Vaccine Effectiveness in Preventing Influenza-Associated Hospitalizations During Pregnancy: A Multi-Country Retrospective Test Negative Design Study, 2010–2016.” Clinical Infectious Diseases 68, no. 9 (April 24, 2019): 1444–53.https://doi.org/10.1093/cid/ciy737.