Despite repeated public health communications urging pregnant women to seek the H1N1 flu vaccine, a small but significant number of pregnant patients are declining to get the new flu shot, local obstetricians say.

The doctors said women most frequently express concern about thimerosal, a mercury-based preservative that has been used in all of the flu shot batches the state has received so far. Women have also said they're worried the vaccine seems too risky because it is new.

"There's two camps of people," said Dr. Ashish Chaudhari, an obstetrician at Concord Women's Care. "People who are very interested in getting it and want to know how soon they can get it. And the other part of the population that is adamant that they don't want to get it, because of unfounded fears about the safety of the medication."

Numerous large scientific studies have failed to link thimerosal to any health complications, but now-debunked theories that the additive could be linked to autism have spooked some future parents, Chaudhari and other obstetricians said.

Pregnant women are considered a key risk group for H1N1, or swine flu, because they seem to be particularly vulnerable to severe disease, hospitalization, miscarriage and death.

"We definitely encourage our pregnant women to consider vaccination," said Dr. Martha Morgan, the chief of obstetrics at Dartmouth-Hitchcock Concord. "Their immune system can't fight it, and there are people dying."

As a result, pregnant women have moved to the front of the line to get the state's first vaccine doses. But their priority status means they are being offered the first shots the state receives. So far, the vaccines have all come in multi-dose vials containing thimerosal, which is used to prevent contamination.

Originally, state health officials hoped thimerosal-free shots would arrive quickly, and they planned to send those shots to obstetricians to head off mercury fears.

"We were under the impression that we would be receiving the preservative-free vaccine very rapidly," said Jennifer Dearborn, a spokeswoman for Concord Hospital, which temporarily delayed vaccine distribution to ob-gyn practices while it waited for preservative-free shots. "That has changed."

The Centers for Disease Control and Prevention, the American College of Obstetricians and Gynecologists, the American Medical Association, and New Hampshire public health officials, among other authorities, all say that both the preservative and the H1N1 flu vaccine are safe for pregnant women.

"There have been no science-based data that document that it causes harm in any way," said Chris Adamski, the state's chief of disease control.

But with the long-swirling rumors about a link between mercury and autism - and a concern among some women that the vaccine is untested because it is new - some are still opting out.

"We don't have any scientific reports that support that, but the whole vaccine-and-autism thing, it's complicated, and it's out there," said Dr. Monelle Bisson, an obstetrician at Integrative Women's Health in Franklin, who has had some patients turn down a vaccine. "The government said it's not, but then some people don't believe what the government says."

Stacy Serzans of Warner, who is more than six months pregnant, said she already received a seasonal flu shot but will not get an H1N1 shot, because she feels uncomfortable being a "guinea pig" for a new vaccine.

"I just feel like there's too many unknowns out there about it," she said.

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