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Risk of immune thrombocytopenic purpura after measles-mumps-rubella immunization in children

Eric K France1, Jason Glanz, Stanley Xu

  • 1Department of Preventive Medicine, Kaiser Pemanente Colorado, Denver, CO 80231, USA. eric.k.france@kp.org

Pediatrics
|March 4, 2008
PubMed

Insights

The measles-mumps-rubella (MMR) vaccine may increase the risk of immune thrombocytopenia purpura (ITP) in children. This study found that 76% of ITP cases in toddlers were linked to the MMR vaccine, causing 1 case per 40,000 doses.

Area of Science:

  • Pediatric immunology
  • Vaccine safety research
  • Epidemiology

Background:

  • Previous small studies suggested a link between the measles-mumps-rubella (MMR) vaccine and immune thrombocytopenia purpura (ITP).
  • Further investigation was warranted to confirm this association and quantify the risk.

Purpose of the Study:

  • To evaluate the association between the MMR vaccine and the incidence of ITP in children.
  • To determine the risk of ITP following MMR vaccination in different age groups.

Main Methods:

  • A retrospective cohort study using the Vaccine Safety Datalink database.
  • Identified children aged 1-18 years who received the MMR vaccine.
  • Defined ITP cases based on platelet count (< or = 50,000/microL) with clinical bleeding and normal blood counts.
  • Calculated incidence rates and incident rate ratios (IRRs) for exposed and unexposed periods, focusing on ages 12-23 months.

Main Results:

  • Over 1 million MMR vaccine doses were administered to 1,036,689 children, with 259 confirmed ITP cases.
  • The incidence rate ratio for ITP was highest in children aged 12-15 months (IRR=7.10).
  • Boys aged 12-15 months had a significantly higher IRR (14.59) compared to girls (3.22).
  • Approximately 76% of ITP cases in 12-23 month olds were attributable to the MMR vaccine, estimating 1 case per 40,000 doses.

Conclusions:

  • The MMR vaccine administered in the second year of life is associated with an increased risk of developing immune thrombocytopenia purpura.
  • The findings highlight a specific risk period for ITP following MMR vaccination, particularly in young children.
Abstract

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