VACCINE ADMINISTRATION AND THE DEVELOPMENT OF IMMUNE THROMBOCYTOPENIC PURPURA IN CHILDREN

Monday, 1st of September 2014

[source]Human Vaccine and Immunotherapeutics[|source]

Thrombocytopenia is an adverse event that has been associated with vaccine administration, and may limit vaccine use because information regarding which vaccines it may follow, its real incidence and severity, the risk of chronic disease, or the possibility of recurrences after new doses of the same vaccine is poorly diffused among parents and a relevant number of physicians. In this report, the authors write a review article review that aims to clarify the real importance of thrombocytopenia as an adverse event and discuss how it may interfere with recommended vaccination schedules. They document that the only vaccine for which there is a demonstrated cause-effect relationship is MMR but, also in this case, the incidence of immune thrombocytopenic purpura (ITP) is significantly lower than that observed during the natural course of the diseases that the vaccine prevents.  More details on risk of ITP after vaccination and MMR vaccine-associated ITP are accessible at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3899154/

 

ABSTRACT

The most important reasons cited by the opponents of vaccines are concerns about vaccine safety. Unlike issues such as autism for which no indisputable documentation of direct relationship with vaccine use is available, immune thrombocytopenic purpura (ITP) is an adverse event that can really follow vaccine administration, and may limit vaccine use because little is known about which vaccines it may follow, its real incidence and severity, the risk of chronic disease, or the possibility of recurrences after new doses of the same vaccine. The main aim of this review is to clarify the real importance of thrombocytopenia as an adverse event and discuss how it may interfere with recommended vaccination schedules. The available data clearly indicate that ITP is very rare and the only vaccine for which there is a demonstrated cause-effect relationship is the measles, mumps and rubella (MMR) vaccine that can occur in 1 to 3 children every 100,000 vaccine doses. However, also in this case, the incidence of ITP is significantly lower than that observed during the natural diseases that the vaccine prevents. Consequently, ITP cannot be considered a problem limiting vaccine use except in the case of children suffering from chronic ITP who have to receive MMR vaccine. In these subjects, the risk-benefit ratio of the vaccine should be weighed against the risk of measles in the community.