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Letter to the editor
Editor, – I refer to the article 'Are we there yet? - Travel along the information highway seeking evidence-based medicine' (Aust Prescr 2001;24:116-9). I enjoyed this problem-based article on influenza vaccination but was surprised that the authors did not suggest consulting the Australian Immunisation Handbook as their first search strategy. To solve the problem I pulled the 7th edition (2000) off the shelf, looked up the index on influenza, flicked to page 140, skimmed to recommendation 4 regarding pregnant women on page 144 and found:
'Influenza vaccine is safe for pregnant women. Pregnant women who fall into one of the above risk categories should be vaccinated. In addition, there is evidence from a number of studies that pregnant women, particularly during the second and third trimester, are at increased risk of influenza-associated complications. The US Centers for Disease Control estimates that an average of 1-2 hospitalisations among pregnant women could be prevented for every 1,000 pregnant women immunised. It is therefore recommended that all women who will be in the second or third trimester of pregnancy during the influenza season be vaccinated in advance, so that they will be protected during that period.'
Time: 45 seconds!
The Australian Immunisation Handbook is also available on the internet at: http://www.health.gov.au/pubhlth/immunise/publications.htm (albeit as a 2.6 meg PDF file)!
To me, this exercise shows the clear value of independent immunisation/therapeutic guidelines produced by expert colleagues who have distilled the evidence into authoritative recommendations. It also shows the deficiencies of the Commonwealth Department of Health web search engine which apparently does not currently index their own PDF documents!
Dr Ken Harvey
School of Public Health
La Trobe University
- The Australian immunisation handbook. National Health and Medical Research Council. 7th ed. Canberra: Australian Government Publishing Service; 2000.