Cited by 165Platelet Disorders and TreatmentsVirology and Viral DiseasesPharmacovigilance and Adverse Drug Reactions

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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, for the Vaccine Safety Datalink Team·2008·PEDIATRICS

DOI 10.1542/peds.2007-1578

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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 < or = 50,000/microL 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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“They have also been applied across a wide range of adverse events, including, but not limited to purpuras (Miller et al., 2001; France et al., 2008; Stowe et al., 2008), autisms (Taylor et al.”
Background
Measles, Mumps, Rubella Vaccine (PRIORIX): Recommendations of the Advisory Committee on Immunization Practices — United States, 2022
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“[38,39], or a self-controlled risk interval design (1 study, 1%) [40] with the SCCS design.”
Method
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Rubella vaccine
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“5 per 100,000 doses) for ITP, respectively [28,29].”
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Sicherheit von Impfstoffen
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Background
Frequently asked questions on seven rare adverse events following immunization
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Platelet and Blood Vessel Disorders
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Rubella Vaccines
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“MMR vaccine is associated with an increased incidence of ITP of 1 case per 30– 40 000 doses of MMR, defined as thrombocytopenia developing within 42 days of exposure [5], an incidence sixfold higher than acute ITP of childhood.”
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Measles Vaccines
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Authors: France, E. K., Glanz, J., Xu, S., Hambidge, S., Yamasaki, K., Black, S. B., Marcy, M., Mullooly, J. P., Jackson, L. A., Nordin, J., Belongia, E. A., Hohman, K., Chen, R. T., Davis, R., & for the Vaccine Safety Datalink Team
Affiliations: Department of Preventive Medicine
Kaiser Permanente (US)
Kaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California, Oakland, California
Group Health Cooperative (US)
Regions Hospital (US)
Marshfield Clinic Research Foundation (US)
Harvard Pilgrim Health Care (US)
Centers for Disease Control and Prevention (US)
ORCID: Glanz, Jason
Xu, Stanley
Hambidge, Simon
Jackson, Lisa A.
Nordin, James
Belongia, Edward A.
Hohman, K.
Chen, Robert T.
Davis, Robert
Venue: PEDIATRICS
Publisher: American Academy of Pediatrics (AAP)
Published: 2008-03-01
Volume: 121
Issue: 3
Pages: e687-e692
ISSN: 0031-4005 (ISSN-L)
1098-4275
DOI: 10.1542/peds.2007-1578
OpenAlex: W2007741934
Cited by: 165
References: 17
Citations by year: 2026: 4 · 2025: 7 · 2024: 7 · 2023: 11 · 2022: 14 · 2021: 16 · 2020: 6 · 2019: 3 · 2018: 3 · 2017: 9 · 2016: 6 · 2015: 11 · 2014: 8 · 2013: 14 · 2012: 12
FWCI: 7.28
Type: journal article
Language: en
Open access: closed
Locations: PEDIATRICS (publishedVersion)
PubMed (publishedVersion)
Funders: Centers for Disease Control and Prevention
Topics: Health Sciences › Medicine › Hematology › Platelet Disorders and Treatments
Health Sciences › Medicine › Epidemiology › Virology and Viral Diseases
Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
Keywords: idiopathic thrombocytopenic purpura, MMR vaccine, vaccine adverse events, children, platelet count, incidence rate ratio, attributable risk, infants, sex differences
MeSH terms: Adolescent, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Immunization Schedule, Male, Purpura, Thrombocytopenic, Registries, Retrospective Studies, Severity of Illness Index, United States, Cohort Studies, Incidence, Poisson Distribution, Age Distribution, Sex Distribution, Risk Assessment, Measles-Mumps-Rubella Vaccine

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Risk of Immune Thrombocytopenic Purpura After Measles-Mumps-Rubella Immunization in Children

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