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Idiopathic thrombocytopenic purpura and MMR vaccine
E Miller1, P Waight, C P Farrington
1Immunisation Division, Public Health Laboratory Service Communicable Disease Surveillance Centre, Colindale, London NW9 5EQ, UK. e.miller@phls.co.uk
Abstract:
A CAUSAL ASSOCIATION BETWEEN MEASLES: mumps-rubella (MMR) vaccine and idiopathic thrombocytopenic purpura (ITP) was confirmed using immunisation/hospital admission record linkage. The absolute risk within six weeks of immunisation was 1 in 22 300 doses, with two of every three cases occurring in the six week post-immunisation period being caused by MMR. Children with ITP before MMR had no vaccine associated recurrences.
Insights
The measles-mumps-rubella (MMR) vaccine is causally linked to idiopathic thrombocytopenic purpura (ITP). The risk is low, with most cases occurring within six weeks of vaccination.
Area of Science:
- Immunology
- Vaccinology
- Pediatrics
Background:
- Idiopathic thrombocytopenic purpura (ITP) is a bleeding disorder.
- The measles-mumps-rubella (MMR) vaccine is widely administered.
- Previous studies suggested a possible link between MMR and ITP.
Purpose of the Study:
- To investigate a potential causal association between the MMR vaccine and ITP.
- To quantify the risk of ITP following MMR vaccination.
Main Methods:
- Utilized immunisation and hospital admission record linkage.
- Analyzed cases of ITP occurring post-vaccination.
Main Results:
- Confirmed a causal association between MMR vaccine and ITP.
- The absolute risk of ITP within six weeks of vaccination was 1 in 22,300 doses.
- Two-thirds of ITP cases in the six-week post-immunisation period were attributed to MMR.
- Children with pre-existing ITP did not experience vaccine-associated recurrences.
Conclusions:
- The MMR vaccine is causally associated with an increased risk of ITP.
- The absolute risk of MMR-associated ITP is low.
- MMR vaccination does not appear to cause recurrence in children with prior ITP.