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Review
. 2023 Nov 25;9(1):22.
doi: 10.1186/s40794-023-00206-9.

Immune thrombocytopenic purpura after influenza vaccine administration; a systematic review and meta-analysis

Mohamed Elsaid  1   2 , Arvind Nune  3 , Aml M Brakat  4   5 , Ayush Anand  6   5 , Mahmoud Alashwah  7   5 , Ahmed Maher  8   5 , Nitu Lama  9   5 , Criselle Angeline C Peñamante  10   11   5
Affiliations
Review

Immune thrombocytopenic purpura after influenza vaccine administration; a systematic review and meta-analysis

Mohamed Elsaid et al. Trop Dis Travel Med Vaccines. .

Abstract

Background: The American Society of Haematology defines immune thrombocytopenic purpura (ITP) as a common hematologic disorder characterized by a transient or long-term decrease in platelet counts (< 100 × 109/L.), purpura, and haemorrhagic episodes caused by antiplatelet autoantibodies, with the exclusion of other clinical conditions. We aimed to systematically determine the incidence of ITP in adults and children following influenza vaccination, the duration between vaccination and the occurrence of ITP, and to identify predictors of ITP after the vaccine.

Methods: We searched PubMed, Cochrane Library, Google Scholar, Web of Science, Scopus, and Science Direct. We included primary studies that assessed the occurrence of immune thrombocytopenia in individuals who had received any influenza vaccine (primary or booster dose), regardless of the dosage, preparation, time of administration, or age of the participants. We excluded studies that were (a) Narrative, scoping, and umbrella reviews ;(b) studies with no accessible full text, abstract-only studies, or (c) Overlapping or unreliable data. The risk of bias in the included studies was assessed using the Joanna Briggs Institute (JBI) tool. We categorized studies for qualitative analysis based on study design. Descriptive statistics were used to summarize quantitative data, including the incidence of ITP after influenza vaccination.

Results: Out of 729 articles retrieved from the database search, we included 24 studies. All patients identified and included in this systematic review presented with immune thrombocytopenia, determined by their platelet count. The period between vaccination and the occurrence of ITP ranged from (2:35 days). The mean duration was 13.5 days. The analysis revealed a statistically significant incidence rate ratio (IRR) = 1.85,95% CI [1.03-3.32] of ITP occurrence after 42 days.

Conclusions: Influenza-associated ITP is uncommon, self-limiting, non-life-threatening, and curable. None of the patients reported having severe adverse events or death. Further studies are required to confirm the exact incidence of the ITP to better understand the pathophysiology of ITP development post-influenza vaccination.

Keywords: Immune thrombocytopenia (ITP); Influenza vaccine; Meta-analysis.; Platelets; Systematic review.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of included studies
Fig. 2
Fig. 2
Meta-analysis of incidence rate ratio (IRR) of ITP after 42 days of influenza vaccine administration
See this image and copyright information in PMC

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References

    1. Zufferey A, Kapur R, Semple J. Pathogenesis and Therapeutic Mechanisms in Immune Thrombocytopenia (ITP). J Clin Med [Internet]. 2017;6(2):16. Available from: http://www.mdpi.com/2077-0383/6/2/16.
    1. Michel M. Immune thrombocytopenic purpura: epidemiology and implications for patients. Eur J Haematol. 2009;82:3–7. doi: 10.1111/j.1600-0609.2008.01206.x. - DOI - PubMed
    1. Georgi JA, Middeke JM, Bornhäuser M, Matzdorff A, Trautmann-Grill K. Deciphering the genetic basis of immune thrombocytopenia: current evidence for genetic predisposition in adult ITP. Blood Adv. 2023;7(14):3710–24. doi: 10.1182/bloodadvances.2023009949. - DOI - PMC - PubMed
    1. Grimaldi-Bensouda L, Michel M, Aubrun E, Leighton P, Viallard JF, Adoue D, et al. A case-control study to assess the risk of immune thrombocytopenia associated with vaccines. Blood. 2012;120(25):4938–44. doi: 10.1182/blood-2012-05-431098. - DOI - PubMed
    1. Nakayama T, Onoda K. Vaccine adverse events reported in post-marketing study of the Kitasato Institute from 1994 to 2004. Vaccine. 2007;25(3):570–6. doi: 10.1016/j.vaccine.2006.05.130. - DOI - PubMed

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