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Cohort study
Inactivated influenza vaccination in first trimester does not appear to increase risk of birth defects
  1. Annette Regan
  1. School of Public Health, Curtin University, Perth, Australia
  1. Correspondence to Dr Annette Regan, School of Public Health, Curtin University, Perth, WA 6845, Australia; annette.regan{at}

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Commentary on: Kharbanda EO, Vazquez-Benitez G, Romitti PA, et al. First trimester influenza vaccination and risks for major structural birth defects in offspring. J Pediatr 2017;187:234–239.e4.

Implications for practice and research

  • In this cohort study, inactivated influenza vaccination in first trimester did not increase risk of birth defects, which should reassure pregnant women of the safety of influenza vaccination in early pregnancy.

  • Despite evidence supporting the safety of antenatal vaccination, additional research investigating early pregnancy outcomes (ie, miscarriage) would be beneficial.


Pregnant women and their infants are at higher risk of severe outcomes from influenza compared with other groups.1 Vaccination against influenza annually can prevent these severe infections. Despite the health benefits offered by vaccination during pregnancy, uptake of influenza vaccine during pregnancy, particularly early pregnancy, is poor.2 One of the most consistently cited reasons for vaccine refusal among pregnant women …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.