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MMR vaccine and idiopathic thrombocytopaenic purpura
Corri Black1, James A Kaye, Hershel Jick
1Department of Public Health, Aberdeen University, Aberdeen, UK. corri.black@abdn.ac.uk
Aims:
To estimate the relationship between idiopathic thrombocytopaenic purpura (ITP) and the measles, mumps and rubella (MMR) vaccination in children; calculating the relative risk estimate for ITP with in 6 weeks after MMR vaccination and the attributable risk of ITP within 6 weeks after MMR vaccination.
Methods:
Using the General Practice Research Database we identified children with a first-time diagnosis of ITP from a base population of children aged less than 6 years between January 1988 and December 1999. After describing the characteristics of all the children identified with ITP, we focused on cases aged 13-24 months to perform a population-based, case-control analysis to estimate the relative risk of developing ITP within 6 weeks after MMR vaccination. We also calculated the risk of ITP attributable to the MMR vaccination.
Results:
Sixty-three children with a first time diagnosis of ITP were identified; 23 cases were between 13 and 24 months old. The relative risk estimate for ITP within 6 weeks after MMR vaccination, compared to the combined group of unvaccinated children and children vaccinated with MMR more than 26 weeks previously was 6.3 (95% CI 1.3-30.1). The attributable risk of developing ITP within 6 weeks after MMR vaccination was estimated to be 1 in 25,000 vaccinations (95% confidence interval 21,300, 89,400).
Conclusion:
This study confirms the increased risk of ITP within 6 weeks after MMR vaccination. However, the attributable risk of ITP within 6 weeks after MMR vaccination is low.
Insights
The measles, mumps, and rubella (MMR) vaccine is associated with a higher risk of idiopathic thrombocytopaenic purpura (ITP) in children. However, the overall risk of ITP following MMR vaccination remains low.
Area of Science:
- Pediatric Immunology
- Vaccine Safety Research
- Epidemiology
Background:
- Idiopathic thrombocytopaenic purpura (ITP) is a bleeding disorder characterized by low platelet counts.
- The measles, mumps, and rubella (MMR) vaccine is a routine childhood immunization.
- Investigating potential associations between vaccinations and adverse events is crucial for public health.
Purpose of the Study:
- To determine the relationship between the MMR vaccine and the incidence of ITP in children.
- To calculate the relative risk and attributable risk of ITP following MMR vaccination.
Main Methods:
- A population-based case-control study was conducted using the General Practice Research Database.
- Children under 6 years old diagnosed with ITP between January 1988 and December 1999 were identified.
- A specific analysis focused on children aged 13-24 months to assess ITP risk within 6 weeks post-MMR vaccination.
Main Results:
- Sixty-three children were diagnosed with ITP; 23 were aged 13-24 months.
- The relative risk of ITP within 6 weeks after MMR vaccination was 6.3 (95% CI 1.3-30.1).
- The attributable risk of ITP within 6 weeks of MMR vaccination was estimated at 1 in 25,000 vaccinations.
Conclusions:
- This study confirms an elevated risk of ITP within 6 weeks after MMR vaccination.
- Despite the increased relative risk, the attributable risk of ITP following MMR vaccination is low.