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Vaccinations are not associated with inhibitor development in boys with severe haemophilia A

H Platokouki1, K Fischer2, S C Gouw3

  • 1Haemophilia-Haemostasis Unit, St. Sophia Children's Hospital, Athens, Greece.

Haemophilia : the Official Journal of the World Federation of Hemophilia
|December 16, 2017
PubMed

Insights

Routine paediatric vaccinations given near factor VIII (FVIII) infusions do not increase inhibitor development risk in previously untreated patients (PUPs) with severe haemophilia A. Data suggest FVIII can be administered during routine vaccinations without increasing inhibitor risk.

Area of Science:

  • Haematology
  • Immunology
  • Paediatrics

Background:

  • Inhibitor development in severe haemophilia A is complex.
  • The relationship between paediatric vaccinations and inhibitor development in previously untreated patients (PUPs) receiving factor VIII (FVIII) is not well understood.

Purpose of the Study:

  • To investigate if paediatric vaccinations administered close to FVIII exposure increase inhibitor development risk in PUPs with severe haemophilia A within their first 75 exposure days (EDs).

Main Methods:

  • A cohort of 375 PUPs with severe haemophilia A from the PedNet Registry was analyzed.
  • Vaccination timing relative to FVIII infusion (within 24, 72, or 120 hours) was compared to inhibitor development.
  • Cox regression models were used to calculate hazard ratios for inhibitor risk.

Main Results:

  • Inhibitor development occurred in 20.5% of patients (77/375).
  • No significant association was found between vaccinations near FVIII and inhibitor development.
  • Inhibitor rates were similar or lower when vaccinations were given close to FVIII compared to when they were not.

Conclusions:

  • The study found no evidence that routine paediatric vaccinations administered near FVIII exposure increase inhibitor development in PUPs with severe haemophilia A.
  • Current data do not support withholding FVIII treatment during routine vaccination schedules.
Abstract

Keywords:
inhibitorspaediatric vaccinationssevere haemophilia A

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