Anticoagulation UK

17 December 2020

COVID – 19 Vaccine and anticoagulants

The British Society of Haematology advises that patients with bleeding disorders or taking anticoagulants or antiplatelet medications, require special consideration as there is a slightly increased risk of bleeding due to the intra-muscular route of administration.

  • Patients on standard intensity anticoagulation with warfarin (target INR 2.0 – 3.0) can receive intra-muscular injections as long as the most recent INR is <3.0. There is no need to re-check the INR solely for the purposes of vaccination.
  • Patients on maintenance therapy with Direct Oral Anticoagulants (Apixaban, Dabigatran, Edoxaban and Rivaroxaban) can delay the dose on the day of vaccination until after the intra-muscular injection but do not need to miss any doses.
  • Patients on single agent anti-platelet therapy (e.g. aspirin or clopidogrel) can continue on these medications without any adjustment.
  • Patients with higher intensity anti-thrombotic treatment, for example warfarin with a target INR > 3.0 or dual antithrombotic medications, should be managed on an individual basis.
  • The bleeding risk can be reduced by application of firm pressure at the injection site for at least 5 minutes afterwards.
  • Patients on a full dose of heparin or fondaparinux injections, should also be able to have the vaccine. The daily dose can be delayed until after the injection but there is no need to miss any doses.

If an individual has a history of allergic reaction, please advise the healthcare professional before you have your vaccination.


ACUK cannot provide individual medical advice around your anticoagulation therapy and whether you should have the vaccination. If you have any concerns, please speak with your anticoagulation clinic or GP.