Vaccination in hemophilic children: Challenges, innovations, and future directions

Dorina Agachi 1, 2, *, Valentin Țurea 1, 3 and Galina Eșanu 1, 3

1 Department of Pediatrics, Nicolae Testemițanu State University of Medicine and Pharmacy, Chişinău, Republic of Moldova.
2 Valentin Ignatenco Municipal Children's Clinical Hospital, Chişinău, Republic of Moldova.
3 Mother and Child Institute, Chişinău, Republic of Moldova.
 
Research Article
World Journal of Biology Pharmacy and Health Sciences, 2024, 20(02), 162–170.
Article DOI: 10.30574/wjbphs.2024.20.2.0863
Publication history: 
Received on 24 September 2024; revised on 03 November 2024; accepted on 05 November 2024
 
Abstract: 
Introduction: Hemophilia, an inherited disorder primarily affecting blood clotting due to deficiencies in clotting factors VIII or IX, presents complex challenges for vaccination. Children with hemophilia require vaccinations to prevent infections that may exacerbate their bleeding disorder. However, traditional intramuscular vaccination poses bleeding risks, necessitating specialized administration methods and careful post-vaccination care.
Purpose: This study examines the efficacy and safety of vaccination in pediatric hemophilia patients, emphasizing the importance of individualized protocols to manage bleeding risks effectively. It explores recent advancements, including needle-free technologies, the potential of gene therapy, and mRNA vaccines.
Materials and Methods: The study synthesizes current guidelines from global health organizations, hemophilia management protocols, and clinical studies on vaccine safety in hemophilia. It highlights techniques such as subcutaneous administration, clotting factor prophylaxis, and the use of fine-gauge needles to minimize bleeding complications.
Results: Findings indicate that with appropriate management, hemophilic children achieve adequate immune responses to vaccines, with reduced bleeding risks. Emerging technologies, such as microneedle patches, jet injectors, and gene therapy, offer promising safer vaccination alternatives. Additionally, mRNA vaccines demonstrate strong immunogenicity without the need for live-virus vectors, reducing complication risks.
Conclusions: Vaccination, when adapted to hemophilia-specific needs, remains essential for infection prevention in this vulnerable population. Newer vaccine technologies and individualized care protocols enhance safety and efficacy, contributing to improved quality of life and long-term health outcomes for hemophilic children.
 
Keywords: 
Hemophilia; Pediatric vaccination; Bleeding disorders; MRNA vaccines; Gene therapy; Microneedle patches
 
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