Thrombosis Canada Encourages Patients on Anticoagulant (Blood Thinning) Therapy to Receive a Vaccine to Protect Against COVID-19

“In response to Thrombosis Canada learning of inconsistent information provided to healthcare professionals and patients about the COVID-19 vaccine and anticoagulation therapy, our members and leading Canadian medical experts, are issuing immediate guidance on this subject to clarify criteria for current and future vaccinations,” said Dr. James Douketis, President, Thrombosis Canada, and Director of Vascular Medicine, Staff Physician in Vascular Medicine and General Internal Medicine at St. Joseph’s Healthcare, Hamilton, Ontario. “Thrombosis Canada is emphasizing that any bleeding risk at the vaccine injection site due to anticoagulant therapy and that may result in a hematoma (muscle bruise) is greatly outweighed by the benefits of the vaccine.”

To ensure the safety and protection of all patients on anticoagulation therapy, Thrombosis Canada has issued the following guidance, practical tips and resources for healthcare professionals and patients to encourage all people on therapy to protect themselves. (Guidance can be found at: https://thrombosiscanada.ca/wp-uploads/uploads/2020/12/Antithrombotics-and-COVID-19-Vaccines-Expert-Guidance.pdf and https://thrombosiscanada.ca/covid-19/)

For patients currently taking warfarin:

• Thrombosis Canada encourages patients who are taking warfarin treatment to receive vaccinations, including the COVID-19 vaccine.
• There is a small risk of bruising at the vaccination injection site, but Thrombosis Canada does not expect any serious effects related to being on blood thinning treatment.
• Thrombosis Canada suggests that after the vaccine injection prolonged pressure for 3 to 5 minutes is applied to the injection site to reduce bruising.
• There is no need to measure the blood thinning level (INR test) just before receiving a vaccination; you should continue INR testing according to the schedule recommended by your doctor.

For patients currently taking a newer blood thinner, one of apixaban (Eliquis), dabigatran (Pradaxa), edoxaban (Lixiana), or rivaroxaban (Xarelto):

• Thrombosis Canada encourages patients who are taking blood thinning (anticoagulant) treatment to receive vaccinations, including the COVID-19 vaccine.
• There is a small risk of bruising at the vaccination injection site, but Thrombosis Canada does not expect any serious effects related to being on blood thinning treatment.
• Thrombosis Canada suggests that after the vaccine injection prolonged pressure for 3 to 5 minutes is applied to the injection site to reduce bruising.

For patients currently taking Aspirin (acetylsalicylic acid) or a similar drug because of a previous heart attack or stroke:

• Thrombosis Canada encourages patients who are taking Aspirin or similar drugs like clopidogrel (Plavix) or ticagrelor (Brillinta) to receive vaccinations, including the COVID-19 vaccine.
• There is a small risk of bruising at the vaccination injection site, but Thrombosis Canada does not expect any serious effects related to being on blood thinning treatment.
• Thrombosis Canada suggests that after the vaccine injection prolonged pressure for 3 to 5 minutes is applied to the injection site to reduce bruising.

Bottom line, as Thrombosis Canada member Dr. Menaka Pai of Hamilton, Ontario says, “You can get the COVID-19 vaccine if you’re on blood thinners. Mask up, stay six feet apart, maintain your household bubble, and review the Thrombosis Canada practical tips to understand how to get the vaccine safely.” Dr. Pai is Head of Service, Benign Hematology, Hamilton Health Sciences, and Associate Professor, Division of Hematology & Thromboembolism, Department of Medicine, McMaster University, Hamilton, Ontario.

Thrombosis Canada will continue to provide new guidance or any change guidance (as required) as the COVID-19 vaccines are more broadly distributed. To monitor guidance, visit the Thrombosis Canada website at https://thrombosiscanada.ca and follow @ThrombosisCan on Twitter.

Disclaimer:

Please note that the recommendations contained herein must be viewed as general guidelines based on current knowledge. Their application must be adapted to individual patients. Thrombosis Canada assumes no responsibility or liability arising from any error or omission or from the use of any information contained herein. You must not rely on the information in this document as an alternative to medical advice from your doctor or other professional healthcare provider.

About Thrombosis Canada

Thrombosis Canada comprises a membership that includes the most eminent and internationally recognized thrombosis experts globally. Members have made many significant contributions to the body of knowledge in vascular medicine and disseminated that knowledge through hundreds of peer-reviewed publications, as well leading the development of international clinical practice guidelines.

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