Abstract
Background
Haemophilia is an inherited bleeding disorder characterised by a deficiency in coagulation factors, leading to an increased risk of bleeding, including after procedures such as immunisation. While immunisation is crucial for preventing infectious diseases, it poses a bleeding risk in people with haemophilia, particularly when administered intramuscularly.
Aims
This study aims to assess the incidence of bleeding complications following immunisation and the use of prophylactic measures among people with haemophilia (PwH) at a haemophilia treatment centre (HTC) in Manipal, India.
Methods
A descriptive cross-sectional study was adopted with a purposive sample of 65 PwH. Data was collected using a demographic proforma and a structured questionnaire on post-immunisation complications and the use of prophylactic measures. Data was collected from the PwH and the caregivers of PwH through an interview. The analysis is reported using descriptive and inferential statistics.
Results
Sixty-five PwH were included in the study (55 (84.6%) haemophilia A; 10 (15.3%) haemophilia B). The study found that 23.1% of participants experienced bleeding complications following intramuscular immunisation, while 76.9% of participants did not experience any bleeding complications. The prophylactic measures reported include administration of clotting factor concentrates, close monitoring for bleeding symptoms, and using icepacks and compressions. The shift towards subcutaneous immunisation was evident, with 83.1% receiving their first immunisation subcutaneously, and 100% receiving subsequent immunisations via the subcutaneous route post-diagnosis. Additionally, 56.9% received clotting factor replacement therapy prior to immunisation, significantly reducing the risk of bleeding.
Conclusion
This study gives an overview of the incidence of bleeding complications following immunisations and the prophylactic measures used to prevent it. It is evident that there has been a shift towards subcutaneous immunisation and a decrease in cases of bleeding complications among PwH.
