The government should think twice before blaming GPs for too few pregnant women having the flu vaccine, especially as it has done so little to address women’s concerns over vaccination in pregnancy.

Another year and another argument is brewing about how many people have had the flu jab.

The news that three-quarters of mums-to-be have skipped vaccination that can protect them against the potentially lethal H1N1 pandemic flu strain should set alarm bells ringing at the DH in England.

After all, it is 11 months to the day since its CMO Dame Sally Davies called for 60% of mums-to-be to have the jab in 2011/12, and the NHS will fall short of this target.

Instead, the DH’s response to the figures has been far from helpful. First, it appeared to play down the CMO’s target. ‘This is only the second year when we have recommended that all pregnant women should have the seasonal flu vaccine,’ a spokesman said.

Then, the department appeared to cast the blame for poor uptake on primary care. ‘It remains important that health professionals do their utmost to target and provide effective arrangements for pregnant women to be vaccinated,’ it said.

Perhaps it is trying to deflect attention to avoid a repeat of the criticism it received last winter, when ministers scrapped the NHS’s traditional annual flu vaccine awareness campaign.

Following this decision, fewer than one-in-10 (7.8%) of expectant mothers had received the vaccine by mid-December 2010. Uptake only rose when the media began reporting rising complications and deaths. But not before a public outcry from doctors, including from the RCGP’s then chairman Professor Steve Field, who blamed poor uptake on the lack of such a campaign.

This winter, there is yet to be a spike of flu cases at all. And so with flu out of the media spotlight, vaccine uptake among pregnant women has again faltered, even though the same dangerous pandemic flu strain is circulating as last year.

This is not a surprise, argued RCGP health protection lead Dr Maureen Baker.

Dr Baker is a sceptic of the need for a campaign, and says it is difficult to judge how much impact a flu awareness campaign would have had on pregnant women.

Although last winter’s glut of news stories about pregnant women dying from flu put an ‘extremely powerful pressure on people’ to have the vaccine, the same effect is not guaranteed from a government-issued early awareness campaign, she believes.

‘There’s a difference between [a media campaign] when there is no immediate threat, and when people are very ill. It’s a different kind of awareness,’ she said.

But even with the lack of a significant flu outbreak this winter, people are still being admitted to intensive care and dying from flu right now. As long as such a substantial number of pregnant women remain at risk from flu, the debate about the need for such a campaign, or other approaches, must go on.

More to the point, the NHS should not simply rely on media coverage to raise interest in vaccination.

By their very nature, these warnings may come too late to protect many people – the outbreak is already underway when the news breaks – and could inundate GP practices with requests for the vaccine, as witnessed last year.

Dr Baker may be correct when she says there is ‘a huge entrenched resistance’ to vaccination in pregnancy. If that is the case, the DH needs to work much harder at the public health message around the flu jab, and convince expectant mums that it is vital to protect themselves.

The standard invitation letter from GPs to get vaccinated can only do so much.