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School Vaccinations

Preparing for School Vaccinations with an Inherited Bleeding Disorder

By Michelle Lowe, RN, Senior Director of Clinical Services

Published July 6, 2021


While this school year may not look like any other, some things remain the same. Vaccinations are required by the state for any students going to school to help prevent serious diseases such as polio, whooping cough and tetanus. It is important to know how those vaccinations are administered to children with inherited bleeding disorders.

According to St. Jude Children’s Research Hospital, your child’s nurse or doctor should follow a specific protocol for administering vaccines. For a child with an inherited bleeding disorder, these are the recommended steps:

  • Only two vaccines at a time with one in each thigh. No more than two vaccines per single doctor’s appointment.
  • Give just under the skin instead of in a muscle. With a subcutaneous injection, your child is less likely to bleed than when the needle goes into a muscle.
  • Injected into the top of the thigh if possible.
  • After the vaccine is given, the care provider should press on the spot with a sterile gauze and hold an ice pack over it to help stop any bleeding.
  • Another strategy is to align the vaccine with the regularly scheduled prophylaxis dose of FVIII and FIX, given the morning of the scheduled vaccine injection. If prophylaxis FVIII/FIX is given prior to the vaccine, then the route can be intramuscular or according to the normal vaccine schedule.

You can always ask your child’s doctor or nurse how the shot is typically administered. If they say in the muscle, ask if there are other options such as under the skin or via a liquid or nose spray. If the primary care physician has concerns with a subcutaneous administration of the shot, please have them reach out to the HTC to discuss their questions.

If you aren’t sure which immunizations are mandatory for school and child care attendance in Georgia, you can visit the Georgia Department of Public Health website for required immunizations by age group.