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The Pediatric Infectious Disease Journal 2003; 22(2):119-123

Thrombocytopenia after immunization of Canadian children, 1992 to 2001

TAJ JADAVJI, MD; DAVID SCHEIFELE, MD; SCOTT HALPERIN, MD; OTHER MEMBERS OF THE CANADIAN PAEDIATRIC SOCIETY/HEALTH CANADA, IMMUNIZATION MONITORING PROGRAM (IMPACT), OTTAWA, CANADA

Background.

Thrombocytopenia occasionally follows immunization of children, especially after administration of measles-containing vaccines. The purpose of this study was to describe the clinical features of postimmunization thrombocytopenia, with emphasis on the rate of complications and outcome.

Methods.

A prospective survey was conducted by 12 pediatric centers in Canada during 1992 to 2001. At each center a nurse monitor searched for inpatient cases. Cases were defined as having onset of clinical signs or laboratory measures of thrombocytopenia (platelet count, <50 × 109/l) within 30 days after immunization. Cases were described in a standardized manner, including follow-up data as available.

Results.

Sixty-one cases were detected, an average of 6 per year or ~1 case per 15 000 general hospital admissions. Median age of cases was 13 months. The mean platelet count at diagnosis was 8.6 × 109/l. Most cases (79%) followed measles-containing vaccines. Only 1 child had a serious (fatal) complication. Platelet counts returned to normal within 30 days of onset in 46 of 57 children (80.7%) with information available. Five children (8.2%) had persistent or intermittent thrombocytopenia for 3 months or more.

Conclusion.

Thrombocytopenia associated with routine immunization of children is rare and usually benign, resolving within 1 month in most children.
Key words: Immunization; thrombocytopenia; vaccine safety; measles vaccine

Accepted for publication Oct. 30, 2002.

Reprints not available.

The Pediatric Infectious Disease Journal 2003; 22(2):119-123
Copyright © 2003 Lippincott Williams & Wilkins
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