A patient with a bleeding disorder such as hemophilia may develop a hematoma following an injection.
Person at risk: moderate to severe coagulopathy
Maximum risk: intramuscular injections
Recommendations to reduce the risk:
(1) Use an oral vaccine if possible.
(2) Administer the vaccine subcutaneously or intradermally if possible.
(3) If an intramuscular injection is required:
(3a) Try to administer the vaccine at a time when coagulation is optimum (before anticoagulation, just after a platelet infusion or Factor VIII administration).
(3b) Use the smallest needle gauge possible (23 mm or smaller diameter).
(3c) Apply firm pressure to the site immediately afterwards for several minutes without rubbing.
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