Immunizations and Hemophilia

Kids and adults with bleeding disorders can and should receive vaccines
Author: Melanie Padgett Powers

Children and adults with bleeding disorders can and should receive the recommended immunizations for their age group. These vaccinations are often given by their primary care physician.

Most vaccinations can be given subcutaneously, or under the skin, instead of intramuscularly, or into the muscle, to reduce the risk of a muscle bleed. However, some healthcare providers may prefer to give intramuscular injections using a smaller needle in a larger muscle, like the thigh, according to “Caring for Your Child,” published by the National Hemophilia Foundation.

Primary care physicians should contact your hemophilia treatment center (HTC) with any questions, particularly about intramuscular injections. HTCs can also instruct you on whether factor infusion is needed before an intramuscular injection.

Children and adults with bleeding disorders may develop bruises at the site of the immunization. Treating the area with ice can help reduce the bruising and ease discomfort.

In addition to the recommended vaccine schedule, the hepatitis A and hepatitis B vaccines are strongly recommended for everyone in the bleeding disorders community.

You can stay updated on the recommended vaccines by age group through the Centers for Disease Control and Prevention’s yearly immunization schedules. Schedules are listed for children (birth through age 6), adolescents (ages 7 through 18) and adults. There is also a “catch-up” schedule to help people who’ve missed vaccines get back on track.

[Steps for Living: Keeping up-to-date with a child's vaccinations]

Preteens and Teens Need Vaccines, Too

As children reach middle school and high school, parents may not think about immunizations as regularly. But older kids need vaccinations, too, including a tetanus booster and a meningitis vaccine.

The CDC recommends all preteens ages 11–12 be vaccinated against meningitis with the meningococcal conjugate vaccine. A booster dose should be given at age 16 because current data show that vaccine protection wanes in most adolescents within five years. If a teenager hasn’t had the meningitis vaccine, the CDC recommends parents talk to the teen’s doctor about getting the vaccine now, particularly if the teenager is preparing to move into a college dorm or military barracks. Bacterial meningitis, which can cause brain damage, hearing loss, learning disabilities and death, is more commonly diagnosed among preteens and young adults.

Other Vaccines to Consider

Parents may also want to consider the human papillomavirus (HPV) vaccine for their children. Some types of HPV can cause cervical cancer and genital warts. The CDC recommends the HPV vaccine be given at ages 11–12. All girls and women ages 11 to 26 should be vaccinated with the three-dose HPV series. The vaccine has also been approved for boys and men ages 9 through 26 for protection against genital warts.

Another important vaccine to consider for your family is the influenza vaccine. CDC recommends a flu vaccine every year for everyone 6 months and older, including immunocompromised people, such as those with HIV. Immunocompromised people should not use the FluMist® nasal spray because it contains a live form of the vaccine; it is only recommended for people through age 49. Flu season runs from October through May, often peaking in January or February.

Jennifer Domm, MD, a hematologist at Vanderbilt Children’s Hospital in Nashville, Tennessee, encourages parents to talk over vaccination recommendations with their HTC and to stay updated on vaccination schedules. “Any child who gets any of these routine childhood diseases that can be prevented can experience severe symptoms,” she says. “Overall, the benefits of vaccinations certainly outweigh the risks.”