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

Eric K. France, Jason Glanz, Stanley Xu, Simon Hambidge, Kristi Yamasaki, Steve B. Black, Michael Marcy, John P. Mullooly, Lisa A. Jackson, James Nordin, Edward A. Belongia, K. Hohman, Robert T. Chen, Robert Davis

Research output: Contribution to journalArticle

92 Citations (Scopus)

Abstract

background. The measles-mumps-rubella vaccine has been associated with immune thrombocytopenia purpura in 2 small studies. methods. By using the Vaccine Safety Datalink, we identified measles-mumps-rubella-vaccinated children aged 1 to 18. A case of immune thrombocytopenia purpura was defined as a patient with a platelet count of &50 OOO/μL with clinical bleeding and normal red and white blood cell indices. The immune thrombocytopenia purpura incidence rates during exposed (42 days after vaccination) and unexposed time periods were determined. A retrospective cohort of vaccinated children was used to determine incident rate ratios for children aged 1 to 18 years, 12 to 23 months, and 12 to 15 months. results. A total of 1 036 689 children received 1 107 814 measles-mumps-rubella vaccinations; there were 259 confirmed patients with immune thrombocytopenia purpura. Because only 5 exposed cases occurred after age 2, analyses were limited to children aged 12 to 23 months. Exposed patients aged 12 to 23 months had lower median platelet counts than those who were unexposed and had similar median duration of illness (11 vs 10 days). The Incident rate ratio was highest for children aged 12 to 15 months at 7.10. The incident rate ratio for boys aged 12 to 15 months was 14.59, and the incident rate ratio for girls in the same age group was 3.22. Seventy-six percent of immune thrombocytopenia purpura cases in children aged 12 to 23 months were attributable to measles-mumps-rubella vaccination. This vaccine causes 1 case of immune thrombocytopenia purpura per every 40 000 doses. conclusion. Measles-mumps-rubella vaccine that is given in the second year of life is associated with an increased risk of immune thrombocytopenia purpura.

Original languageEnglish (US)
JournalPediatrics
Volume121
Issue number3
DOIs
StatePublished - Mar 1 2008
Externally publishedYes

Fingerprint

Mumps
Purpura
Idiopathic Thrombocytopenic Purpura
Rubella
Measles
Immunization
Measles-Mumps-Rubella Vaccine
Vaccination
Platelet Count
Vaccines
Leukocytes
Age Groups
Erythrocytes
Hemorrhage
Safety
Incidence

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

Risk of immune thrombocytopenic purpura after measles-mumps-rubella immunization in children. / France, Eric K.; Glanz, Jason; Xu, Stanley; Hambidge, Simon; Yamasaki, Kristi; Black, Steve B.; Marcy, Michael; Mullooly, John P.; Jackson, Lisa A.; Nordin, James; Belongia, Edward A.; Hohman, K.; Chen, Robert T.; Davis, Robert.

In: Pediatrics, Vol. 121, No. 3, 01.03.2008.

Research output: Contribution to journalArticle

France, EK, Glanz, J, Xu, S, Hambidge, S, Yamasaki, K, Black, SB, Marcy, M, Mullooly, JP, Jackson, LA, Nordin, J, Belongia, EA, Hohman, K, Chen, RT & Davis, R 2008, 'Risk of immune thrombocytopenic purpura after measles-mumps-rubella immunization in children', Pediatrics, vol. 121, no. 3. https://doi.org/10.1542/peds.2007-1578
France, Eric K. ; Glanz, Jason ; Xu, Stanley ; Hambidge, Simon ; Yamasaki, Kristi ; Black, Steve B. ; Marcy, Michael ; Mullooly, John P. ; Jackson, Lisa A. ; Nordin, James ; Belongia, Edward A. ; Hohman, K. ; Chen, Robert T. ; Davis, Robert. / Risk of immune thrombocytopenic purpura after measles-mumps-rubella immunization in children. In: Pediatrics. 2008 ; Vol. 121, No. 3.
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abstract = "background. The measles-mumps-rubella vaccine has been associated with immune thrombocytopenia purpura in 2 small studies. methods. By using the Vaccine Safety Datalink, we identified measles-mumps-rubella-vaccinated children aged 1 to 18. A case of immune thrombocytopenia purpura was defined as a patient with a platelet count of &50 OOO/μL with clinical bleeding and normal red and white blood cell indices. The immune thrombocytopenia purpura incidence rates during exposed (42 days after vaccination) and unexposed time periods were determined. A retrospective cohort of vaccinated children was used to determine incident rate ratios for children aged 1 to 18 years, 12 to 23 months, and 12 to 15 months. results. A total of 1 036 689 children received 1 107 814 measles-mumps-rubella vaccinations; there were 259 confirmed patients with immune thrombocytopenia purpura. Because only 5 exposed cases occurred after age 2, analyses were limited to children aged 12 to 23 months. Exposed patients aged 12 to 23 months had lower median platelet counts than those who were unexposed and had similar median duration of illness (11 vs 10 days). The Incident rate ratio was highest for children aged 12 to 15 months at 7.10. The incident rate ratio for boys aged 12 to 15 months was 14.59, and the incident rate ratio for girls in the same age group was 3.22. Seventy-six percent of immune thrombocytopenia purpura cases in children aged 12 to 23 months were attributable to measles-mumps-rubella vaccination. This vaccine causes 1 case of immune thrombocytopenia purpura per every 40 000 doses. conclusion. Measles-mumps-rubella vaccine that is given in the second year of life is associated with an increased risk of immune thrombocytopenia purpura.",
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AU - Hambidge, Simon

AU - Yamasaki, Kristi

AU - Black, Steve B.

AU - Marcy, Michael

AU - Mullooly, John P.

AU - Jackson, Lisa A.

AU - Nordin, James

AU - Belongia, Edward A.

AU - Hohman, K.

AU - Chen, Robert T.

AU - Davis, Robert

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N2 - background. The measles-mumps-rubella vaccine has been associated with immune thrombocytopenia purpura in 2 small studies. methods. By using the Vaccine Safety Datalink, we identified measles-mumps-rubella-vaccinated children aged 1 to 18. A case of immune thrombocytopenia purpura was defined as a patient with a platelet count of &50 OOO/μL with clinical bleeding and normal red and white blood cell indices. The immune thrombocytopenia purpura incidence rates during exposed (42 days after vaccination) and unexposed time periods were determined. A retrospective cohort of vaccinated children was used to determine incident rate ratios for children aged 1 to 18 years, 12 to 23 months, and 12 to 15 months. results. A total of 1 036 689 children received 1 107 814 measles-mumps-rubella vaccinations; there were 259 confirmed patients with immune thrombocytopenia purpura. Because only 5 exposed cases occurred after age 2, analyses were limited to children aged 12 to 23 months. Exposed patients aged 12 to 23 months had lower median platelet counts than those who were unexposed and had similar median duration of illness (11 vs 10 days). The Incident rate ratio was highest for children aged 12 to 15 months at 7.10. The incident rate ratio for boys aged 12 to 15 months was 14.59, and the incident rate ratio for girls in the same age group was 3.22. Seventy-six percent of immune thrombocytopenia purpura cases in children aged 12 to 23 months were attributable to measles-mumps-rubella vaccination. This vaccine causes 1 case of immune thrombocytopenia purpura per every 40 000 doses. conclusion. Measles-mumps-rubella vaccine that is given in the second year of life is associated with an increased risk of immune thrombocytopenia purpura.

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