Will Fear Make Pregnant Women Shun Swine Flu Vaccine?

Doctors fear safety worries may overshadow pregnant patients' need for the shot.

Aug. 28, 2009— -- New Yorker Deirdre Hykal is precisely the type of person doctors hope will get the swine flu vaccine first.

Hykal is pregnant -- a fact that moves her to the front of the line to receive the vaccine, as health officials have warned that pregnant women appear to be more susceptible to swine flu than their non-pregnant counterparts.

But despite this, Hykal has her misgivings about the jab.

"It's sort of nerve wracking, perhaps because you're the guinea pigs," Hykal told ABC News' Sharyn Alfonsi. "But I don't know what's worse ... getting sick from the vaccine or sick from the swine flu. So it's a tough decision."

Doctors are increasingly worried that pregnant women like Hykal, fearing side effects from the swine flu vaccine for themselves or their unborn babies, will skip the shots -- even though these women are among the priority groups to receive them.

Dr. Gerald Joseph, president of the American College of Obstetricians and Gynecologists, sent a letter on Thursday to doctors in the organization pressing them to urge their pregnant patients to get the shots when they become available.

"The American College of Obstetricians and Gynecologists has joined with a coalition of prenatal and pediatric health care provider organizations to urge pregnant women to take steps to prevent influenza and to seek early treatment," Joseph wrote in the letter. "Your action to prevent and treat influenza in your pregnant patients is of critical importance."

The recommendation that pregnant women be among the first to receive the swine flu vaccine comes after a study released last month showed that pregnant women are four times more likely to be hospitalized with the illness than other people.

But some pregnancy experts say the vaccine could be a tough sell to pregnant women who worry that the shots could have an ill effect on their babies.

"Pregnant women attending our clinics are very concerned about swine flu and the risk to their health and, more importantly, the impact it might have on their pregnancy and the health of their baby," said Dr. Amanda Cotter, associate professor obstetrics and gynecology at the University of Miami Miller School of Medicine.

"All pregnant women should be vaccinated against the seasonal flu, but only 15 percent of pregnant women actually [are]," she said. "The reluctance is because pregnant women are always afraid to take medication in pregnancy and harm their baby."

Dr. Marjorie Greenfield, director of general obstetrics and gynecology at the University Hospitals Case Medical Center's MacDonald Hospital for Women in Cleveland, agreed that convincing some mothers to get the vaccine could be an uphill battle.

"I know a lot of people are worried about vaccines for their children, and many mothers-to-be don't want to take any unnecessary medications or treatments during pregnancy," she said. "So I am sure we will get lots of questions about whether it is safe to take this vaccine."

Swine Flu More Dangerous for Pregnant Women, Doctors Say

Ironically, pregnant women are the ones who stand to benefit the most from the swine flu vaccine, doctors say, as the disease appears to be much more severe for these women.

"We have good evidence that flu is more dangerous to pregnant women than to the general public," Greenfield said.

"We are very worried about how big this epidemic of H1N1 may be this year, and pregnant women who get H1N1 will be at increased risk of severe illness and death," she said. "There is no reason to believe that the immunization will be unsafe and good reason to believe that H1N1 has the potential to make pregnant women very sick."

And some doctors report that they have already seen firsthand the potentially devastating effects of swine flu in pregnant patients.

"We did have a pregnant mother in late spring who developed H1N1 flu and was critically ill," said Dr. Ian Holzman, chief of the Division of Newborn Medicine at Mount Sinai Medical Center in New York. "She delivered prematurely, and the baby was ill, but there was no evidence that the baby had influenza.

"The risks of the immunization are surely less than the risk of influenza in the mother," he said.

ABC News' Sharyn Alfonsi contributed to this report.