Safety of Immunization for Children with Immune Thrombocytopenia

Author:

Wang Xiangshi1,Feng Tianxing2ORCID,Wang Chuning1,Li Jingjing1,Ge Yanling1,Zhai Xiaowen3,Wang Hongsheng3,Zeng Mei1

Affiliation:

1. Department of Infectious Disease, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai 201102, China

2. Department of Pediatrics, Shanghai Clinical Research and Trial Center, Shanghai 201203, China

3. Department of Hematology, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai 201102, China

Abstract

Vaccine hesitancy is a common issue for children with immune thrombocytopenia (ITP) in China. The objective of this paper is to assess the immunization statuses of children with ITP, analyze the possible relationship between immunization and thrombocytopenia, and evaluate the safety of immunization after ITP remission. We included 186 children with an ITP history and followed up with them for two years after receiving re-immunization recommendations. The participants had an overall age-appropriate vaccine coverage of 57.9%. Vaccine-associated thrombocytopenia occurred in 99 (53.2%, 95% CI = 46.06–60.26) children ranging from 0 to 34 days following immunization, with 14 vaccines involved. One hundred and fifty-four (82.3%, 95% CI = 76.72–87.54) children were advised to restart immunization, whereas 32 (17.2%, 95% CI = 12.46–23.28) were advised to postpone partial or full vaccination. Following the follow-up, 150 (80.6%, 95% CI = 74.37–85.68) children completed the catch-up immunization, whereas 27 (14.5%, 95% CI = 10.17–20.30) partially completed it. Four patients with thrombocytopenia relapsed following the re-immunization. Incomplete catch-up immunization was related to the factors of chronic thrombocytopenia, vaccine-associated thrombocytopenia, and the relapse of ITP following re-immunization. ITP may occur after immunization with vaccines other than measles-containing vaccines. Re-immunization in children with ITP generally does not result in a relapse, regardless of whether the previous thrombocytopenia was vaccine-associated.

Funder

the Shanghai Municipal Three-Year Action Plan for Strengthening the Construction of the Public Health System

the Shanghai Municipal Health Commission Health Policy Research Project

Publisher

MDPI AG

Reference34 articles.

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