THROMBOCYTOPENIC PURPURA FOLLOWING MEASLE S, MUMPS AND RUBELLA VACCINATION

A retrospective epidemiological survey was conducted to evaluate the i ncidence and characteristics of thrombocytopenic purpura (TP) reported in France following measles, mumps or rubella vaccination with monova lent or multivalent vaccines. All confirmed cases of TP reported spont aneously either to the French Regional Drug Surveillance Centres or to the manufacturer (Pasteur-Merieux Serums & Vaccins) between 1984 and June 30 1992 were reviewed. Sixty cases of TP were reported i.e an inc idence/100.000 doses of 0.23 and 0.17 for measles or rubella vaccines respectively given alone, to 0.87 for combined measles-rubella vaccine and 0.95 for MMR vaccine. The mean age was 21 +/- 12 months and the d elay of diagnosis was 16 +/- 6 days after vaccination,Thrombopenia was severe (mean platelet count: 8000 +/- 6000/mm(3)) and always associat ed with pur pura The immediate outcome was favourable in 89.5 per cent of cases. Vaccine-associated TP appears to be similar to acute childh ood idiopathic thrombocytopenic purpura but the clear temporal relatio nship between MMR vaccination and the occurrence of TP make a causal r elationship highly plausible. Acute TP seems a rare complication of me asles-rubella and MMR vaccination but clinicians had to be informed of the possibility of their occurence. Acute TP following Vaccination sh ould be reported by physicians to their Regional Drug Surveillance Cen tre.