COVID-19 vaccination programme: Information for healthcare practitioners

Administering COVID-19 vaccine to individuals with a bleeding disorder
Individuals with bleeding disorders may be vaccinated intramuscularly if, in the opinion of a doctor familiar with the individual’s bleeding risk, vaccines or similar small volume intramuscular injections can be administered with reasonable safety by this route.
If the individual receives medication/treatment to reduce bleeding, for example treatment for haemophilia, intramuscular vaccination can be scheduled shortly after such medication/treatment is administered. A fine needle (23 or 25 gauge) should be used for the vaccination, followed by firm pressure applied to the site (without rubbing) for at least 2 minutes (ACIP, 2019). The individual/carer should be informed about the risk of haematoma from the injection.

Administering COVID-19 vaccine to individuals taking anticoagulants
Individuals on stable anticoagulation therapy, including individuals on warfarin who are up-to-date with their scheduled INR testing and whose latest INR was below the upper threshold of their therapeutic range, can receive intramuscular vaccination. If in any doubt, consult with the clinician responsible for prescribing or monitoring the individual’s anticoagulant therapy.

Period of observation following immunisation with COVID-19 vaccine
Recipients of COVID-19 vaccine should be observed for any immediate reactions during the period they are receiving any post-immunisation information and making a subsequent appointment if required. There is no evidence to support the practice of keeping patients under longer observation.
As syncope (fainting) can occur following vaccination, all vaccinees should either be driven by someone else or should not drive for 15 minutes after vaccination.