Consensus statements on vaccination in patients with haemophilia—Results from the Italian haemophilia and vaccinations (HEVA) project. Issue 4 (16th April 2019)

• Record Type: Journal Article
• Authors: Santagostino, Elena; Riva, Agostino; Cesaro, Simone; Esposito, Susanna; Matino, Davide; Mazzucchelli, Renata Ilde; Molinari, Angelo Claudio; Mura, Rosamaria; Notarangelo, Lucia Dora; Tagliaferri, Annarita; Di Minno, Giovanni; Clerici, Mario
• Other Names: Ambaglio Chiara investigator.; Brigida Aru Anna investigator.; Baldacci Erminia investigator.; Barillari Giovanni investigator.; Basso Maria investigator.; Bernasconi Sayla investigator.; Bertamino Marta investigator.; Bertoni Elisa investigator.; Biasoli Chiara investigator.; Federica Biguzzi Eugenia investigator.; Bonetti Elisa investigator.; Borchiellini Alessandra investigator.; Bulgarelli Simona investigator.; Cabibbo Sergio investigator.; Cantori Isabella investigator.; Castaman Giancarlo investigator.; Castiglia Paolo investigator.; Coluccia Antonella investigator.; Coppetelli Ugo investigator.; Coppola Antonio investigator.; Cultrera Dorina investigator.; De Candia Erica investigator.; Delios Grazia investigator.; Di Gennaro Leonardo investigator.; Di Gregorio Patrizia investigator.; Di Minno Matteo investigator.; Dragani Alfredo investigator.; Pietro Ettorre Cosimo investigator.; Franchini Massimo investigator.; Galli Massimo investigator.; Gallo Giovanni investigator.; Giordano Paola investigator.; Giuffrida Gaetano investigator.; Iannaccaro Piergiorgio investigator.; Lassandro Giuseppe investigator.; Lazzareschi Ilaria investigator.; Linari Silvia investigator.; Luciani Matteo investigator.; Macchi Silvia investigator.; Malcangi Giuseppe investigator.; Malizia Raniero investigator.; Marietta Marco investigator.; Marino Renato investigator.; Massoud Michela investigator.; Gabriella Mazzucconi Maria investigator.; Milan Marta investigator.; Morfini Massimo investigator.; Napolitano Mariasanta investigator.; Pasca Samantha investigator.; Pedrazzi Paola investigator.; Peyvandi Flora A. investigator.; Piscitelli Lydia investigator.; Pollio Berardino investigator.; Preti Paola investigator.; Quintavalle Gabriele investigator.; Radossi Paolo investigator.; Raso Simona investigator.; Ricca Irene investigator.; Rocino Angiola investigator.; Santoro Cristina investigator.; Carlotta Santoro Rita investigator.; Sarolo Lucia investigator.; Schiavoni Mario investigator.; Schiavulli Michele investigator.; Sciancalepore Patrizia investigator.; Luisa Serino Maria investigator.; Mario Siragusa Sergio investigator.; Sottilotta Gianluca investigator.; Svahn Johanna investigator.; Valdrè Lelia investigator.; Cristina Vedovati Maria investigator.; Zanon Ezio investigator.;
• Is Part Of: Haemophilia. Volume 25:Issue 4(2019)
• Page Start: 656
• Page End: 667
• Publication Date: 2019-04-16
• Subjects: bleeding disorder -- factor VIII inhibitor -- haemophilia -- immunization -- vaccination; Hemophilia -- Periodicals; 616.1572005
• DOI: 10.1111/hae.13756
• Languages: English
• ISSNs: 1351-8216

Abstract

Abstract : Vaccination against communicable diseases is crucial for disease prevention, but this practice poses challenges to healthcare professionals in patients with haemophilia. Poor knowledge of the vaccination requirements for these patients and safety concerns often result in vaccination delay or avoidance. In order to address this issue, a panel of 11 Italian haemophilia and immunization experts conducted a Delphi consensus process to identify the main concerns regarding the safe use of vaccines in patients with haemophilia. The consensus was based on a literature search of the available evidence, which was used by the experts to design 27 consensus statements. A group of clinicians then rated these statements using the 5‐point Likert‐type scale (1 = strongly disagree; 5 = strongly agree). The main issues identified by the expert panel included vaccination schedule for haemophilic patients; protocol and optimal route of vaccine administration; vaccination of haemophilic patients with antibodies inhibiting coagulation factor VIII (inhibitors); and vaccination and risk of inhibitor development. This manuscript discusses these controversial areas in detail supported by the available literature evidence and provides evidence‐ and consensus‐based recommendations. Overall, participants agreed on most statements, except those addressing the potential role of vaccination in inhibitor formation. Participants agreed that patients with haemophilia should receive vaccinations according to the institutional schedule for individuals without bleeding disorders; however, vaccination of patients with haemophilia requires comprehensive planning, taking into account disease severity, type and route of vaccination, and bleeding risk. Data also suggest vaccination timing does not need to take into consideration when the patient received factor VIII replacement.