Hamostaseologie 2019; 39(S 01): S1-S92
DOI: 10.1055/s-0039-1680228
Poster
P09 Haemophilia 3
Georg Thieme Verlag KG Stuttgart · New York

Vaccination in Patients with Hemophilia - Results from an Online Survey among German Haemostaseologists

C. Pfrepper
1   Division of Hemostaseology, University Hospital Leipzig, Leipzig, Germany
,
M. Olivieri
2   Department of Pediatric Hemostaseology, Dr. von Hauner Children's Hospital, Munich, Germany
,
M. Sigl-Kraetzig
3   Kinder- und Jugendarztpraxis Blaubeuren, Blaubeuren, Germany
,
C. Königs
4   Department of Pediatrics and Adolescent Medicine, University Hospital Frankfurt, Frankfurt, Germany
,
J. Wendisch
5   Public Health Department Dresden, Center for Vaccinations, Dresden, Germany
,
M. Krause
6   Division of Hemostaseology, German Diagnostic Clinic, Wiesbaden, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
13 February 2019 (online)

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Introduction: There are no consistent recommendations regarding the administration of vaccines in patients with hemophilia. Subcutaneous administration is still recommended despite the lack of approval for some vaccines in Germany. Regarding intramuscular injection adequate factor substitution is required. An association between factor substitution and proximity of vaccination was postulated as a risk factor for inhibitor development.

Methods: An online survey initiated by a working group of the “Ständige Kommission Hämophilie der GTH” was conducted among german haemophilia treating physicians about their current practice of vaccination.

Results: A total of 39 haemostaseologists (56% CCC, 28% HTC) took part in the survey. 51% administered vaccines depending on the severity of haemophilia. 28% recommend exclusively subcutaneous vaccinations, 31% perform subcutaneous vaccination without approval but in case of existing data and 13% vaccinate only according to approval status. 71% recommend a fixed time interval between factor substitution and vaccination. After subcutaneous vaccination 48% have seen rare or no complications. After intramuscular injection 68% of the haemophilia-treating physicians have seen rare and 32% no complications. The most commonly reported complications after subcutaneous vaccination were: local skin reactions (49%) and granulomas (26%). After intramuscular vaccination the most mentioned complications were: granulomas (51%), local skin reactions (44%) and muscular bleeds (33%). Vaccine titers were controlled by 42% after subcutaneous and by 19% after intramuscular vaccination.

Conclusion: Current practice of vaccination in patients with haemophilia is heterogenous. The way of application depends mostly on the severity of the bleeding disorder. Most haemophilia-treating physicians apply vaccines subcutaneously despite the lack of approval. Complications in subcutaneous application as well as in intramuscular application are rare. Further data and recommendations on the way of application are urgently needed.