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World Thalassemia Day 2021: Can You Receive Blood Transfusion Immediately After Covid-19 Vaccination?

World Thalassemia Day 2021: Can You Receive Blood Transfusion Immediately After Covid-19 Vaccination?
World Thalassemia Day is celebrated annually on May 8 to raise awareness about the disease, its symptoms and ways to live with it. @Shutterstock

On World Thalassaemia Day, experts have advised people with thalassemia to get COVID-19 vaccines on priority basis as they are more vulnerable to the viral infection and its complications.

Written by Longjam Dineshwori |Published : May 8, 2021 9:15 AM IST

Thalassemia is an inherited blood disorder in which the body doesn't make enough of hemoglobin, a protein found in the red blood cells (RBCs) that is responsible for carrying oxygen to tissues. Less than normal amounts of hemoglobin in your RBCs can cause anemia, leaving you fatigued. People with more severe forms of thalassemia often require frequent blood transfusions on regular basis, possibly every few weeks. With Covid-19 cases increasing in alarming rate in India, experts have been advising people to get vaccinated against the deadly virus to reduce the severity of the infection and chances of death. But is COVID-19 vaccine safe for thalassemia patients? It is all right to receive blood transfusion immediately before/after Covid-19 vaccination? Today, on the occasion of the World Thalassemia Day, we have two experts Dr Pradeep Mahajan, Regenerative Medicine Researcher, and Dr. Ganesh Jaishetwar, Consultant Hematologist, Hemato-Oncologist & Bone Marrow Transplant Physician, Yashoda Hospitals, Hyderabad to clear these doubts and throw light on COVID-19 complications associated with thalassemia.

Are currently approved COVID-19 vaccines safe for people with thalassaemia?

Dr. Jaishetwar: It is absolutely safe for Thalassaemic patients to take the COVID-19 vaccine. In fact, Thalassaemics should receive the vaccine on priority basis as they are most vulnerable to COVID-19 infections and its complications.

Dr Mahajan: Yes, the Health Ministry of our country has listed patients with thalassemia as eligible for the COVID-19 vaccination. There are no known risks of either of the two vaccinations currently available in India for COVID-19. However, patients should discuss with their healthcare provider about their current health status and any history of allergic reactions before deciding to take the vaccination. Patients with thalassemia are in a constant immunocompromised state and the vaccination would help minimize the severity, in case they are infected in future by the coronavirus.

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Can a thalassemia patient receive blood transfusion immediately before/after getting the vaccine?

Dr. Jaishetwar: Yes, Thalassemia patients can receive blood transfusion after or before the vaccination and transfusions have to be maintained as per their regular schedule.

Dr Mahajan: There are no specific guidelines or evidence instructing against blood transfusion immediately before/after vaccination in patients with thalassemia. Therefore, the physician/haematologist may decide regarding blood transfusion after considering the general health status of the patient and requirement.

Few things thalassemic patientsshouldkeep in mind while receiving blood transfusion during the pandemic

Dr. Jaishetwar: Although theoretically there is risk of any virus transmission with blood transfusion, there is no literature evidence of blood transmitted COVID-19 infection. So, it is absolutely safe to receive blood transfusion by Thalassemics as per their transfusion schedule. Another important challenge during this pandemic is the shortage of blood inventory in blood banks across the globe as blood donors need to refrain from blood donation for 2-4 weeks after the vaccination. In this regard, all the healthy volunteer blood donors are urged, and the recommendation is to donate blood before their vaccination.

Dr Mahajan: Global organizations have currently not recommended any specific precautions before/after transfusion in thalassemia patients, as there are no known risks of transmission of SARS-CoV-2 through blood. Nonetheless, a stricter screening and selection criteria must be followed to eliminate any possibility of asymptomatic COVID-19 individuals or those with a travel history and recent contact with COVID-19 positive individuals from donating blood products. In addition, screening of the donated blood products for viruses should be done and pathogen reduction technologies (if possible) should be adopted to ensure safe transfusion.

The safest possible environment should be ensured for the transfusions, ideally in clinics/centres/hospitals where there are no COVID-19 patients or those being screened for the disease.

What are the possible complications/risks if thalassemia patients get COVID-19?

Dr. Jaishetwar: Just like any normal population, thalassemic patients can acquire COVID infection through droplet spread. However, just like patients with comorbidities, thalassemics too are at high risk of getting severe COVID-19 infection along with associated complications due to chronic anemia, chronic blood transfusion and its associated iron overload and associated organ dysfunctions like heart failure, pulmonary hypertension and diabetes etc. Although in many case-series from Europe and North America, most infected Thalassemics have mild to moderate infection with severity and mortality comparable to that of the general population.

Dr Mahajan: Both transfusion and non-transfusion dependent thalassemia patients may have risk factors associated with severe COVID-19 infection including iron overload, endocrinopathies like diabetes, splenectomy, and coagulopathy. Thalassemia patients also tend to present with other systemic health issues like heart and/or lung disease, arthritis, increased risk of infections, etc., thus COVID-19 infection could lead to long-term consequences or may even prove fatal.

Moreover, due to their immunocompromised status, if they acquire the infection, they may have prolonged shedding of the virus, thereby potentially increasing the risk of transmission to their family/treatment providers. Thus, prevention of COVID-19 should be the goal, and in cases where the patient acquires the infection, the hematologist and treating physicians should discuss on the best possible treatment protocol to prevent or minimize complications.

World Thalassemia Day is celebrated annually on May 8 to raise awareness about the disease, its symptoms and ways to live with it. The theme of this year is "Addressing Health Inequalities Across the Global Thalassemia Community."