Q and A

Question

Can people with haemophilia and HIV have COVID-19 vaccines? Are there special cautions?

Answer

Yes, the COVID-19 vaccines are recommended for people with HIV and haemophilia. However, many people will need clotting factor treatment immediately before they have the injection. This is because, although rare, people with haemophilia can develop serious bleeding after an intramuscular injection.

There are no problems with the vaccine, just a caution over a potential problem linked to an injection.

The COVID-19 vaccine must be given as an injection into the muscle in your arm. This is even though some vaccines like the flu vaccine can be given either into the muscle or under the skin.

People with haemophilia should only be given the vaccine “if their haemophilia doctor thinks it can be done safely”. This is likely to be true for probably everyone with haemophilia and HIV in the UK. As stated above, some will need factor treatment before having the vaccine.

What extra precautions should people with haemophilia and HIV take for the COVID-19 vaccine?

The following suggestions include:

  • Use a small size needle for the vaccine injection (23 or 25 gauge is recommended in the UK).
  • People with haemophilia and HIV who regularly take clotting factor treatment will need to have treatment to prevent any bleeding just before the vaccine injections.
  • Firm pressure should be applied to the injection site for two minutes afterwards.
  • Some people with moderate haemophilia will not need any treatment.
  • People with haemophilia and HIV who are taking emicizumab should not need any extra treatment before being vaccinated.

What if I have haemophilia and inhibitors to a clotting factor?

If you have been on emicizumab for some time, you should be able to have the COVID vaccination injection without problems and no need of extra treatment.

Please check with your haemophilia centre if you are in this situation.

If you are still in the loading phase of emicizumab, your haemophilia doctor will need to decide what is needed to allow you to be vaccinated without causing any bleeding problems. The loading phase is usually the first 4-6 weeks.

If you are on another treatment, it is also important to check with your haemophilia doctor.

More information about haemophilia and COVID-19 vaccines

The following resources include more information.

COVID-19 vaccination programme Information for healthcare practitioners (see page 16).

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/949063/COVID-19_vaccination_programme_guidance_for_healthcare_workers_December_2020_V3.pdf (PDF)

COVID-19 vaccination guidance for people with bleeding disorders from the World Federation of Haemophilia

Available at https://news.wfh.org/wp-content/uploads/Joint-Guidance-on-COVID-19-Vaccination-Dec-22-Final-1.pdf (PDF)

Green Book chapter 14a (page 7).

https://www.gov.uk/government/publications/covid-19-the-green-book-chapter-14a

This is one of more than 45 questions about COVID vaccines. It was produced by and for people living with HIV.
Q&A on COVID vaccines: are they safe and effective?
https://i-base.info/qa/16330

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