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Yet providers who don't routinely treat pregnant women may not understand flu's risk and the shot's safety record, says Silverman, who helps set ACOG practice guidelines.
Take pharmacists, expected to be key H1N1 vaccinators. Silverman gets occasional phone calls from women who say a pharmacist won't fill the flu-shot prescription he wrote.
"They act like the doctor who prescribed it didn't know what he or she was doing," says Silverman, who settles the standoff by getting the pharmacist on the phone. For every patient who calls, "I know there are at least two who just say, 'Well, OK, I'm not going to do this,' and just walk away."
The American Pharmacists Association is urging its members to follow the CDC's pregnancy guidelines but can't mandate that, and a few stores may still balk, says association chief of staff Mitchel Rothholz.
But some are embracing the potential customers. The large Walgreen's drugstore chain told states that if picked as an H1N1 shot site, it might put get-vaccinated-here signs next to the pregnancy tests, or print vaccine reminders for people who bought prenatal vitamins.
And Louisiana this month lifted its requirement that pharmacists vaccinate by prescription only, making it easier for everyone to get a drugstore flu shot.
Why don't more OBs vaccinate? Largely it's the expense and hassle, but it's not part of routine obstetrician training, says Dr. Stanley Gall of the University of Louisville, an OB and longtime vaccine provider. That's changing as more stock a different vaccine -- against the virus that causes cervical cancer -- and decide they might as well offer flu vaccine, too.
Because so few pregnant women even have another doctor, "the OB office should be a one-stop shop," he says.
On the Net:
CDC info: http://www.cdc.gov/h1n1flu/pregnancy/
Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
Copyright 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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