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Introduction
The pandemic of H1N1 influenza, sometimes called swine
influenza, began during April 2009 and reached Sweden the
same year in early May. In October 2009, a mass vaccination
against H1N1 influenza was started in Sweden. A vaccine
produced by Glaxo Smith Kline (Brentford, Middlesex,
UK) was used, Pandemrix. This vaccine contained inactivated
split influenza virus (A/California/07/2009), squalene
adjuvant and thiomersale preservative.
The official recommendations regarding vaccination during
pregnancy for H1N1 influenza varied between 20 different
European countries and also the type of vaccine used.1
In 12 countries, the recommendation was to only vaccinate
during the second or third trimester. In Sweden, pregnant
women were included in the vaccination programme.
Until recently, studies on H1N1 influenza vaccination
were restricted to small investigations based on only a few
hundred women.2–5 An article in press6 followed 332
women who were vaccinated for H1N1 influenza and compared
them with 1329 nonvaccinated women and found no
significant difference in spontaneous abortion rate or the
rate of congenital malformations. This conclusion was
based on five spontaneous abortions and two infants with
malformations born after vaccination before or during the
first trimester.
A Danish study7 found that 12.9% (n = 7062) of pregnant
women who were vaccinated against H1N1 influenza
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