Vaccine administration and the development of immune thrombocytopenic purpura in children

Valerio Cecinati, Nicola Principi, Letizia Brescia, Paola Giordano, Susanna Esposito

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Pages (from-to)1158-1162
Number of pages5
JournalHuman Vaccines and Immunotherapeutics
Issue number5
Publication statusPublished - May 2013


  • Adverse events
  • Immune thrombocytopenic purpura
  • MMR
  • Platelets
  • Vaccine
  • Vaccine safety

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Pharmacology


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