Vaccines and changes in coagulation parameters in adults on chronic warfarin therapy

A cohort study

Michael L. Jackson, Jennifer C. Nelson, Robert T. Chen, Robert Davis, Lisa A. Jackson

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Purpose: Warfarin is commonly used among patients who receive influenza, pneumococcal, and tetanus and diphtheria toxoid vaccines, and persons on warfarin therapy may also receive Hepatitis A vaccine. There has been concern that vaccinations could potentially alter coagulation parameters in patients on warfarin therapy. We sought to determine whether vaccinations are associated with changes in International Normalized Ratio (INR) in persons on long-term warfarin therapy. Methods: We conducted a retrospective cohort study of 5167 members of Group Health, a health maintenance organization (HMO) in western Washington State, who were aged 18 years and older and who were on stable long-term warfarin therapy between 1 January 1992 and 31 December 2003. We made within-person comparisons between mean INR values in the 28 days after receipt of influenza, pneumococcal, tetanus, or hepatitis A vaccine versus mean INR values during other times. Results: Receipt of influenza vaccine was not associated with a change in INR value (mean change, 0.01; 95% confidence interval (CI) -0,01 to 0.03); similar results were observed for pneumococcal (mean change 0.01; 95%CI -0.07 to 0.09), tetanus (mean change 0.03; 95%CI -0.03 to 0.10), and hepatitis A vaccines (mean change 0.03; 95%CI -0.10 to 0.14). Conclusions: Our results do not suggest that vaccinations lead to clinically significant alterations in coagulation measures among adults on chronic warfarin therapy.

Original languageEnglish (US)
Pages (from-to)790-796
Number of pages7
JournalPharmacoepidemiology and Drug Safety
Volume16
Issue number7
DOIs
StatePublished - Jul 1 2007

Fingerprint

Warfarin
Cohort Studies
International Normalized Ratio
Vaccines
Hepatitis A Vaccines
Confidence Intervals
Diphtheria Toxoid
Vaccination
Tetanus
Human Influenza
Therapeutics
Tetanus Toxoid
Health Maintenance Organizations
Influenza Vaccines
Retrospective Studies
Health

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Pharmacology (medical)

Cite this

Vaccines and changes in coagulation parameters in adults on chronic warfarin therapy : A cohort study. / Jackson, Michael L.; Nelson, Jennifer C.; Chen, Robert T.; Davis, Robert; Jackson, Lisa A.

In: Pharmacoepidemiology and Drug Safety, Vol. 16, No. 7, 01.07.2007, p. 790-796.

Research output: Contribution to journalArticle

Jackson, Michael L. ; Nelson, Jennifer C. ; Chen, Robert T. ; Davis, Robert ; Jackson, Lisa A. / Vaccines and changes in coagulation parameters in adults on chronic warfarin therapy : A cohort study. In: Pharmacoepidemiology and Drug Safety. 2007 ; Vol. 16, No. 7. pp. 790-796.
@article{0fabd73174504656a1abf05ba5d92c54,
title = "Vaccines and changes in coagulation parameters in adults on chronic warfarin therapy: A cohort study",
abstract = "Purpose: Warfarin is commonly used among patients who receive influenza, pneumococcal, and tetanus and diphtheria toxoid vaccines, and persons on warfarin therapy may also receive Hepatitis A vaccine. There has been concern that vaccinations could potentially alter coagulation parameters in patients on warfarin therapy. We sought to determine whether vaccinations are associated with changes in International Normalized Ratio (INR) in persons on long-term warfarin therapy. Methods: We conducted a retrospective cohort study of 5167 members of Group Health, a health maintenance organization (HMO) in western Washington State, who were aged 18 years and older and who were on stable long-term warfarin therapy between 1 January 1992 and 31 December 2003. We made within-person comparisons between mean INR values in the 28 days after receipt of influenza, pneumococcal, tetanus, or hepatitis A vaccine versus mean INR values during other times. Results: Receipt of influenza vaccine was not associated with a change in INR value (mean change, 0.01; 95{\%} confidence interval (CI) -0,01 to 0.03); similar results were observed for pneumococcal (mean change 0.01; 95{\%}CI -0.07 to 0.09), tetanus (mean change 0.03; 95{\%}CI -0.03 to 0.10), and hepatitis A vaccines (mean change 0.03; 95{\%}CI -0.10 to 0.14). Conclusions: Our results do not suggest that vaccinations lead to clinically significant alterations in coagulation measures among adults on chronic warfarin therapy.",
author = "Jackson, {Michael L.} and Nelson, {Jennifer C.} and Chen, {Robert T.} and Robert Davis and Jackson, {Lisa A.}",
year = "2007",
month = "7",
day = "1",
doi = "10.1002/pds.1386",
language = "English (US)",
volume = "16",
pages = "790--796",
journal = "Pharmacoepidemiology and Drug Safety",
issn = "1053-8569",
publisher = "John Wiley and Sons Ltd",
number = "7",

}

TY - JOUR

T1 - Vaccines and changes in coagulation parameters in adults on chronic warfarin therapy

T2 - A cohort study

AU - Jackson, Michael L.

AU - Nelson, Jennifer C.

AU - Chen, Robert T.

AU - Davis, Robert

AU - Jackson, Lisa A.

PY - 2007/7/1

Y1 - 2007/7/1

N2 - Purpose: Warfarin is commonly used among patients who receive influenza, pneumococcal, and tetanus and diphtheria toxoid vaccines, and persons on warfarin therapy may also receive Hepatitis A vaccine. There has been concern that vaccinations could potentially alter coagulation parameters in patients on warfarin therapy. We sought to determine whether vaccinations are associated with changes in International Normalized Ratio (INR) in persons on long-term warfarin therapy. Methods: We conducted a retrospective cohort study of 5167 members of Group Health, a health maintenance organization (HMO) in western Washington State, who were aged 18 years and older and who were on stable long-term warfarin therapy between 1 January 1992 and 31 December 2003. We made within-person comparisons between mean INR values in the 28 days after receipt of influenza, pneumococcal, tetanus, or hepatitis A vaccine versus mean INR values during other times. Results: Receipt of influenza vaccine was not associated with a change in INR value (mean change, 0.01; 95% confidence interval (CI) -0,01 to 0.03); similar results were observed for pneumococcal (mean change 0.01; 95%CI -0.07 to 0.09), tetanus (mean change 0.03; 95%CI -0.03 to 0.10), and hepatitis A vaccines (mean change 0.03; 95%CI -0.10 to 0.14). Conclusions: Our results do not suggest that vaccinations lead to clinically significant alterations in coagulation measures among adults on chronic warfarin therapy.

AB - Purpose: Warfarin is commonly used among patients who receive influenza, pneumococcal, and tetanus and diphtheria toxoid vaccines, and persons on warfarin therapy may also receive Hepatitis A vaccine. There has been concern that vaccinations could potentially alter coagulation parameters in patients on warfarin therapy. We sought to determine whether vaccinations are associated with changes in International Normalized Ratio (INR) in persons on long-term warfarin therapy. Methods: We conducted a retrospective cohort study of 5167 members of Group Health, a health maintenance organization (HMO) in western Washington State, who were aged 18 years and older and who were on stable long-term warfarin therapy between 1 January 1992 and 31 December 2003. We made within-person comparisons between mean INR values in the 28 days after receipt of influenza, pneumococcal, tetanus, or hepatitis A vaccine versus mean INR values during other times. Results: Receipt of influenza vaccine was not associated with a change in INR value (mean change, 0.01; 95% confidence interval (CI) -0,01 to 0.03); similar results were observed for pneumococcal (mean change 0.01; 95%CI -0.07 to 0.09), tetanus (mean change 0.03; 95%CI -0.03 to 0.10), and hepatitis A vaccines (mean change 0.03; 95%CI -0.10 to 0.14). Conclusions: Our results do not suggest that vaccinations lead to clinically significant alterations in coagulation measures among adults on chronic warfarin therapy.

UR - http://www.scopus.com/inward/record.url?scp=34547507822&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34547507822&partnerID=8YFLogxK

U2 - 10.1002/pds.1386

DO - 10.1002/pds.1386

M3 - Article

VL - 16

SP - 790

EP - 796

JO - Pharmacoepidemiology and Drug Safety

JF - Pharmacoepidemiology and Drug Safety

SN - 1053-8569

IS - 7

ER -