Can Anti-D (RhoGAM) be made from unvaccinated blood?

Why the question?

Women, families, clinicians, and birth workers know that Anti-D immunoglobulin is made from blood. And, in recent years, some people have become even more concerned about this. They are asking whether it is possible to request Anti-D made only from the blood of people who have never received an mRNA Covid vaccine.

This is understandable, because people care deeply about the health decisions they make for themselves and their families. And we all make different decisions, and have different concerns. One size doesn’t fit all.

The short answer to their question is no. it isn’t possible to have Anti-D which is made only from unvaccinated blood, and in this blog post I will explain why that is, and share some of the information that has been published on this topic.

What is Anti-D?

Anti-D (which may also be called anti-D, RhoGAM, RhIG, or Rh₀(D) immunoglobulin) is a medicinal product made from donated human blood. It’s actually made from plasma, which is the clear, antibody-rich part of our blood.

Injectable Anti-D contains some very specific antibodies that prevent a woman who is rhesus negative from becoming sensitised to rhesus positive blood cells during pregnancy or childbirth. This is done in the hope of preventing any possible rhesus positive babies that she might later become pregnant with from developing haemolytic disease of the newborn.

As I explain here, Anti-D doesn’t protect the current baby. It is given to protect possible future babies.

There are a number of situations in which Anti-D is offered, both during pregnancy and after birth, and you can find out more about its use in my Anti-D information hub and in my book, Anti-D Explained.

How is Anti-D made?

Anti-D is made from plasma containing high levels of anti-D antibodies.

Sometimes, this plasma comes from people who have naturally developed those antibodies (for example, after a pregnancy or blood transfusion).

In some programmes, Anti-D is also made from the blood of volunteers – usually men, or post-menopausal women – whose immune system has been deliberately stimulated so that they produce the antibodies needed to make Anti-D. In other words, they agree to become sensitised to the D antigen so that Anti-D can be made for those women who want and need it.

What about vaccination status?

It’s understandable that people may wonder whether donor vaccination status could affect plasma products and, if so, whether it’s possible to have Anti-D made from the blood of donors who haven’t been vaccinated. However, understanding a few elements of the Anti-D manufacturing process will help explain why offering Anti-D made solely from the blood of unvaccinated donors isn’t possible.

First, blood services and manufacturers do not screen for whether someone has had an mRNA vaccine before collecting plasma for medicines. There are plenty of things that donors and blood is screened for, but vaccination status isn’t asked for, isn’t recorded on blood donations, and isn’t used to select or label donations for manufacture.

Another factor is that medical blood products such as Anti-D are made from pooled blood, or mixtures of thousands of donations. Even if vaccination status were asked for, it isn’t something that could be controlled or tracked in a process where so many donations are then pooled together during manufacture.

Why is blood pooled to make Anti-D?

There are a few reasons why blood is pooled to make Anti-D. It’s logistically and practically easier to make it in large batches, and the companies who make this tell us that doing so helps ensure consistent quality. Pooling blood allows for the use of modern purification processes and the screening and testing of the whole pool of blood.

One estimate shows that 1g of immunoglobulin contains donations from around 10,000 donors.

Again, with this many donations going into one batch of Anti-D, it’s just not practical or feasible to preserve or control for individual donor characteristics such as vaccination status.

Knowing about this aspect of manufacture does help us answer another question that some people ask, which is about the likelihood that any given dose of Anti-D contains blood from vaccinated donors.

Given that Anti-D is made from pooled blood, that around 10,000 donors’ blood is in each dose, and that roughly 65-80% of people in high-income countries have had a Covid vaccine (although not necessarily an mRNA vaccine, depending on where they live), it is extremely likely that any dose of Anti-D made in the past few years includes blood that has been donated by people who are vaccinated.

Regulatory and Manufacturing Issues

There are a few other reasons which explain why it is highly unlikely that Anti-D made from unvaccinated blood will ever be made available.

The first is that scientific and regulatory bodies don’t regard vaccination status or having had an mRNA vaccine as a safety issue for blood and plasma products. They cite research into blood transfusions which has not shown that receiving blood or plasma from vaccinated donors harms recipients. Scientists who work in this area are confident that vaccines don’t leave lingering active components in blood that would affect safety.

(I discuss the safety of blood products in much more depth in Anti-D Explained.)

Another key issue is that Anti-D has been in short supply in several countries over the past few years, and this is an ongoing problem. There are concerns about whether we have enough Anti-D for those women who do want it. As a result, as one national organisation puts it:

“Unnecessary restrictions related to blood donor eligibility would create significant, costly new burdens, which would need to be absorbed throughout the health care system and state.” (ABBO 2025).

This was also confirmed as being the case in the UK in 2022 by the UK Medicines and Healthcare Products Regulatory Agency.

The bottom line

The bottom line is that it isn’t feasible or possible to make Anti-D solely from the blood of unvaccinated blood donors. This isn’t going to change, both for logistical reasons, and because medical, scientific, and regulatory organisations don’t have concerns about the safety of Anti-D from this perspective.

Safety is key in the manufacturing process, however. Plasma and plasma-derived products in the UK and Europe, for example, are subject to strict regulation by bodies such as the Medicines and Healthcare products Regulatory Agency (MHRA) and the European Medicines Agency (EMA).

These agencies set standards for donor selection, donation screening, pooled plasma testing, fractionation (the process of separating plasma into useful components), and product certification. All licensed Anti-D products have been reviewed to meet those standards before they are used in clinical care. More information and links here.

Where to find out more

If you still have concerns about Anti-D, or want more information before you decide whether it’s right for you, the best thing you can do is to read more, and get yourself informed.

I wrote my book, Anti-D Explained, to help with this. This book explains the issues, answers key questions, and shares information about what we do and do not know about Anti-D and the pros and cons of this from research evidence and current thinking.

Most importantly, you’ll learn enough to help you make an individualised decision.

Anti-D Explained

You can also read more of my articles about Anti-D here:

Anti-D resources

I hope this post and my book helps you to make the decisions that are right for you.

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Books to help you become informed and make the decisions that are right for you…

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