Document Detail


Risk of immune thrombocytopenic purpura after measles-mumps-rubella immunization in children.
MedLine Citation:
PMID:  18310189     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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;
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Pediatrics     Volume:  121     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-03     Completed Date:  2008-03-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e687-92     Citation Subset:  AIM; IM    
Affiliation:
Department of Preventive Medicine, Kaiser Pemanente Colorado, Denver, CO 80231, USA. eric.k.france@kp.org
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Age Distribution
Child
Child, Preschool
Cohort Studies
Female
Follow-Up Studies
Humans
Immunization Schedule
Incidence
Male
Measles-Mumps-Rubella Vaccine / administration & dosage,  adverse effects*
Poisson Distribution
Purpura, Thrombocytopenic / epidemiology*,  etiology,  immunology*
Registries
Retrospective Studies
Risk Assessment
Severity of Illness Index
Sex Distribution
United States
Chemical
Reg. No./Substance:
0/Measles-Mumps-Rubella Vaccine
Comments/Corrections
Comment In:
Pediatrics. 2008 Mar;121(3):625-6   [PMID:  18310214 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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