Lack of effect of influenza immunisation on anticoagulant control in patients on long-term warfarin

Authors

  • Peter MacCallum MD, FRCP, FRCPath,

    Corresponding author
    1. Department of Haematology, Barts and The London NHS Trust, London, UK
    2. Department of Environmental and Preventive Medicine and Centre for Statistics, Barts and The London, Queen Mary's School of Medicine and Dentistry, London, UK
    • Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK.
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  • Manisha Madhani BPharm,

    1. Department of Haematology, Barts and The London NHS Trust, London, UK
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  • Shahrul Mt-Isa BSc,

    1. Department of Environmental and Preventive Medicine and Centre for Statistics, Barts and The London, Queen Mary's School of Medicine and Dentistry, London, UK
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  • Deborah Ashby BSc, MSc, PhD

    1. Department of Environmental and Preventive Medicine and Centre for Statistics, Barts and The London, Queen Mary's School of Medicine and Dentistry, London, UK
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  • No conflict of interest was declared.

Abstract

Purpose

The effect of influenza vaccination on oral anticoagulant control is uncertain but important to establish since anticoagulants are widely used and most patients taking them are candidates for immunisation because of age or underlying cardiac disease. We therefore prospectively evaluated the effect of influenza vaccination on International Normalised Ratio (INR) control in patients on long-term warfarin.

Methods

We undertook a prospective audit of patients on long-term warfarin attending a single hospital anticoagulant clinic who reported receiving influenza vaccination within the 10 days prior to a clinic visit. We compared the stability of anticoagulant control in the 12 months prior to and 10 days after immunisation, restricting analysis to those patients whose warfarin dosage was unchanged before and after vaccination.

Results

Of 106 consecutive patients who reported receiving influenza vaccination within the 10 days prior to a clinic visit, results were evaluable in 78 because the dose of warfarin was unchanged before and after vaccination. Influenza immunisation had no apparent effect on anticoagulant control. No bleeding or thrombotic complications were reported.

Conclusions

Our findings suggest that it is not necessary to routinely monitor the INR more closely after influenza vaccination. Copyright © 2006 John Wiley & Sons, Ltd.

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