Our hemophilia treatment center has been receiving some calls from patients about how the new COVID vaccines and persons with bleeding disorders. We’d like to share with you the National Hemophilia Foundation questions and answers related to the vaccines at the following link which discusses the safety of the vaccines, concerns about the vaccine and gene therapy, and the risk of bleeding with this injection:
Need the vaccine? Learn how to get your shot at Vaccinate.Virginia.gov or call 1-877-VAX-IN-VA. Monday through Saturday, 8am - 6pm. Language translation available, TTY users dial 7-1-1.
We want to highlight one of the questions about the administration of the vaccine. Please see below:
The vaccination is administered intra-muscularly but the smallest gauge needle needs should be used (25-27 gauge), if possible. Some vaccines must be administered using the accompanying needle–syringe combination, and so the use of an alternative needle may not be possible or desirable.
It would be preferable for you to infuse with a factor replacement product prior to or right after the vaccination and applying pressure for 10 minutes after the vaccination. Patients receiving emicizumab may be vaccinated by intra-muscular injection at any time without receiving an additional dose of FVIII. Patients with von Willebrand Disease or rare bleeding disorders should consult with their hematologist regarding special precautions prior to receiving the vaccination. All rare bleeding disorder patients (including those with thrombocytopenia and/or platelet function disorders) should be vaccinated. Patients on anticoagulants should have prothrombin time testing performed within 72 hours prior to injection to determine international normalized ratio (INR); if results are stable and within the therapeutic range, they can be vaccinated intramuscularly.
Following the vaccination, the area should be monitored for hematoma formation immediately for 10 minutes to reduce bleeding and swelling and by self-inspection 2-4 hours later at home to ensure that there is no delayed hematoma. Discomfort at the injection site is to be expected. Discomfort in the arm felt for 1-2 days after injection should not be alarming unless it unless it worsens and is accompanied by swelling.
Additionally, the American College of Obstetricians and Gynecologists (ACOG) has made the following recommendation: COVID-19 vaccines should not be withheld from pregnant individuals who meet criteria for vaccination based on Advisory Committee on Immunization Practices (ACIP)-recommended priority groups….COVID-19 vaccines should be offered to lactating individuals similar to non-lactating individuals when they meet criteria for receipt of the vaccine based on prioritization groups outlined by the ACIP. For the full recommendation, please see: https://www.acog.org/en/advocacy/advocacy-and-covid-19/covid-19-vaccines-and-pregnancy.
As part of our national surveillance project, the HTC is collecting data on patients with bleeding disorders who are diagnosed with COVID-19. If you are diagnosed with COVID-19, please contact the HTC to let us know. If a member of your household has been diagnosed with COVID-19, please review the CDC recommendations for providing care for someone in your home: https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/care-for-someone.html
Coronavirus disease 2019 (COVID-19) is a virus (more specifically, a coronavirus) identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China.