Your Body. Your Baby. Their Flu. ~ Kelly Brogan, MD

babyimagesAs a conventionally trained, dyed-in-the-wool psychiatrist, I learned that mental illness is a manifestation of an imbalance of brain chemicals that can be largely reduced to too little serotonin and/or norepinephrine, too little dopamine, or messed up excitatory signals at the membrane level. These deficits required pharmaceutical intervention for repair, just as one of my attendings once patronizingly said to an inpatient post-suicide attempt: if you had poor vision, you would need glasses. There would just be no way for you to navigate the world without those glasses no matter how much you wanted to.

I don’t believe this anymore. I’ve left the church and I’ve run into the woods where I’m listening to the sermons delivered by the natives there…those who believe in a natural order, in the body’s capacity to heal, in the sanctity of a clean environment, and in the interconnectedness of spirit, nourishment, and movement. But this was a journey for me. I started to open my eyes during my first pregnancy, when I began my fellowship in treating pregnant and postpartum women. I learned how to consent them, and what informed consent really looked like, around treatment with psychotropics in pregnancy and lactation. Many of these women had been on medication for the better part of their adult lives and either found themselves pregnant, were planning to become, or developed symptoms despite treatment. I poured over the literature for hundreds of hours, memorizing authors and statistics, distilling complex analytic concepts, and building a rational path, with some forks in the road, for these women to travel. I helped them to understand the known risks, the unknown risks, the alternatives, and allowed them to assess the perceived benefits. This process would often culminate in a 90-120 minute session involving all and any interested family members and extensive communication with other providers – general psychiatrists, obstetricians, therapists, so that everyone was on the same page.

You can imagine that it began to rub me the wrong way when these very same patients would come in and casually mention that they had gotten a “flu shot”, often without a single medical provider involved (at CVS!), no consent, no discussion. I didn’t know much about the flu vaccine other than that when I entered medical school, pregnant women and babies were in the “contraindicated” demographic. I also knew that doctors, residents and med students almost never got the flu shot voluntarily.

I began to look into the literature through my lens of best quality pregnancy data: a prospective cohort study, well-controlled, looking at outcomes during pregnancy, at birth, and up to 5-7 years of childhood age or longer. I investigated the ingredients (egg proteins and associated unidentified viral DNA from this animal tissue, the allergen gelatin, polysorbate 80 which crosses the blood brain barrier, the carcinogen formaldehyde, the detergent triton x100, sucrose, resin, the antibiotic gentamycin, and thimerosol/mercury) and found that no study has looked at the effect of injecting any one of the ingredients, let alone the combination. I was hoping to find large studies done annually for each preparation assuming that if there were 25,000 cases in the literature of SSRI exposure, there must be at least that for something formally recommended to pregnant women. Hereinlies the important philosophical leap: women are educated to avoid elective exposures to medication in pregnancy. When there is an indicated intervention, medical, pharmaceutical, surgical, the personal risks and benefits are weighed of treatment vs no treatment vs alternatives. But, here we have a one-size-fits-all recommendation with no risk-stratification according to immune status, personal medical history, genetic risk factors, or comorbidities. A formal recommendation of a category C intervention whose package insert states:

Animal reproduction studies have not been conducted with influenza virus vaccine. It is also not known whether influenza virus vaccine can cause fetal harm when administered to a pregnant woman. Although animal reproductive studies have not been conducted, the prescribing health care provider should be aware of the recommendations of the Advisory Committee on Immunization Practices. The ACIP states that if used during pregnancy, administration of influenza virus vaccine after 14 weeks of gestation may be preferable to avoid coincidental association of the vaccine with early pregnancy loss.”

Who is blowing air into this trumpet? I think we know.

To this day, I remain appalled at the double-speak on the part of the CDC around this intervention that has been conclusively found to be ineffective and dangerous in the general population and is grossly understudied in the pregnant population. Here are some tidbits about vaccinating for influenza:

Read full article HERE

~Kelly Brogan, MD

kbroganAs an undergraduate at M.I.T, Dr. Brogan studied Cognitive Neuroscience and worked with Harvard undergraduates to create a public forum for the discussion of alternative medicine, directing conferences for the Hippocratic Society. She attended Cornell Medical School where she was awarded the Rudin Scholarship for Psychiatric Oncology and began her work in Reproductive Psychiatry, which she went on to train in during her residency at NYU/Bellevue. A strong interest in the interface of medicine
and psychiatry led her to pursue a fellowship in Consultation Liaison/Psychosomatic Medicine at NYU/Bellevue/VA Hospital. Since that time, she remains on faculty and has focused her efforts on her private practice where she cares for patients with medical illnesses, as well as women at all stages of their reproductive life cycle. A passion for
holistic living, environmental medicine, and nutrition are the bedrock of her functional medicine practice. She has published in the field of Psycho-Oncology, Women’s Health, Perinatal Mental Health, Alternative Medicine, and Infectious Disease. She is Board Certified in Psychiatry, Psychosomatic Medicine, as well as Board Certified in Integrative and Holistic Medicine. Link to her website HERE and sign up for her newsletter HERE