---
title: "Risk of ITP After First and Second MMR Doses in English Children Born 2000–2019"
id: "pubmed-42771940"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42771940"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42771940/"
doi: "10.1016/j.vaccine.2026.129168"
published_at: "2026-10-24T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Risk of ITP After First and Second MMR Doses in English Children Born 2000–2019
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42771940
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42771940/)
- **DOI:** [10.1016/j.vaccine.2026.129168](https://doi.org/10.1016%2Fj.vaccine.2026.129168)
- **Published At:** 2026-10-24T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- The study linked hospitalised cases of **idiopathic thrombocytopenic purpura (ITP)** to **MMR vaccine** records for children born in England between 2000 and 2019. - Investigators used the self-controlled case-series method to estimate relative incidence in the 6-week risk window after vaccination. - The cohort analysis identified an elevated incidence of ITP in the 6 weeks after the first MMR dose: relative incidence 2.38 (95% CI 2.12–2.67). - Authors calculated an attributable risk following dose 1 of 1 in 42,900 doses; this is the excess ITP events per vaccine doses administered. - For the second MMR dose, the observed relative incidence was 0.96 (95% CI 0.81–1.13), indicating no evidence of increased risk at the population level. - Among 336 children who experienced ITP after dose 1 and subsequently received dose 2, the study team observed no increased ITP risk in the 6-week period after the second dose. - Data indicate that receiving a second **MMR vaccine** dose after an ITP episode following dose 1 did not raise short-term ITP incidence in this linked-hospital dataset. - The article reports methods and primary risk estimates; the source did not supply detailed dosing schedules, absolute counts of all cases beyond the 336 subgroup, or granular demographic breakdowns in the abstract.
## Clinical Analysis & Structured Key Points
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Epub 2026 Sep 22. # The risk of idiopathic thrombocytopenic purpura after first and second measles, mumps, rubella (MMR) vaccine doses in children born in England 2000-2019 [Nick Andrews](https://pubmed.ncbi.nlm.nih.gov/?term=Andrews+N&cauthor_id=42771940)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42771940/#full-view-affiliation-1 "Immunisation and Vaccine Preventable Diseases Department, UK Health Security Agency, London NW9 5EQ, UK. Electronic address: nick.andrews@ukhsa.gov.uk."), [Julia Stowe](https://pubmed.ncbi.nlm.nih.gov/?term=Stowe+J&cauthor_id=42771940)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42771940/#full-view-affiliation-2 "Immunisation and Vaccine Preventable Diseases Department, UK Health Security Agency, London NW9 5EQ, UK."), [Erjola Hani](https://pubmed.ncbi.nlm.nih.gov/?term=Hani+E&cauthor_id=42771940)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42771940/#full-view-affiliation-2 "Immunisation and Vaccine Preventable Diseases Department, UK Health Security Agency, London NW9 5EQ, UK."), [Anna Jeffery-Smith](https://pubmed.ncbi.nlm.nih.gov/?term=Jeffery-Smith+A&cauthor_id=42771940)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42771940/#full-view-affiliation-2 "Immunisation and Vaccine Preventable Diseases Department, UK Health Security Agency, London NW9 5EQ, UK."), [Mary Ramsay](https://pubmed.ncbi.nlm.nih.gov/?term=Ramsay+M&cauthor_id=42771940)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42771940/#full-view-affiliation-2 "Immunisation and Vaccine Preventable Diseases Department, UK Health Security Agency, London NW9 5EQ, UK.") Affiliations Expand ### Affiliations * 1 Immunisation and Vaccine Preventable Diseases Department, UK Health Security Agency, London NW9 5EQ, UK. Electronic address: nick.andrews@ukhsa.gov.uk. * 2 Immunisation and Vaccine Preventable Diseases Department, UK Health Security Agency, London NW9 5EQ, UK. * PMID: **42771940** * DOI: [ 10.1016/j.vaccine.2026.129168 ](https://doi.org/10.1016/j.vaccine.2026.129168) Free article Item in Clipboard # The risk of idiopathic thrombocytopenic purpura after first and second measles, mumps, rubella (MMR) vaccine doses in children born in England 2000-2019 Nick Andrews et al. Vaccine. 2026. Free article Show details Display options Display options Format Abstract PubMed PMID Vaccine Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Vaccine%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Vaccine%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42771940/) . 2026 Oct 24:92:129168. doi: 10.1016/j.vaccine.2026.129168. Epub 2026 Sep 22. ### Authors [Nick Andrews](https://pubmed.ncbi.nlm.nih.gov/?term=Andrews+N&cauthor_id=42771940)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42771940/#short-view-affiliation-1 "Immunisation and Vaccine Preventable Diseases Department, UK Health Security Agency, London NW9 5EQ, UK. Electronic address: nick.andrews@ukhsa.gov.uk."), [Julia Stowe](https://pubmed.ncbi.nlm.nih.gov/?term=Stowe+J&cauthor_id=42771940)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42771940/#short-view-affiliation-2 "Immunisation and Vaccine Preventable Diseases Department, UK Health Security Agency, London NW9 5EQ, UK."), [Erjola Hani](https://pubmed.ncbi.nlm.nih.gov/?term=Hani+E&cauthor_id=42771940)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42771940/#short-view-affiliation-2 "Immunisation and Vaccine Preventable Diseases Department, UK Health Security Agency, London NW9 5EQ, UK."), [Anna Jeffery-Smith](https://pubmed.ncbi.nlm.nih.gov/?term=Jeffery-Smith+A&cauthor_id=42771940)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42771940/#short-view-affiliation-2 "Immunisation and Vaccine Preventable Diseases Department, UK Health Security Agency, London NW9 5EQ, UK."), [Mary Ramsay](https://pubmed.ncbi.nlm.nih.gov/?term=Ramsay+M&cauthor_id=42771940)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42771940/#short-view-affiliation-2 "Immunisation and Vaccine Preventable Diseases Department, UK Health Security Agency, London NW9 5EQ, UK.") ### Affiliations * 1 Immunisation and Vaccine Preventable Diseases Department, UK Health Security Agency, London NW9 5EQ, UK. Electronic address: nick.andrews@ukhsa.gov.uk. * 2 Immunisation and Vaccine Preventable Diseases Department, UK Health Security Agency, London NW9 5EQ, UK. * PMID: **42771940** * DOI: [ 10.1016/j.vaccine.2026.129168 ](https://doi.org/10.1016/j.vaccine.2026.129168) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract We assessed the risk of Idiopathic thrombocytopenic purpura (ITP) after Measles Mumps Rubella vaccine (MMR) doses 1 and 2 in children in England born from 2000 to 2019. After linking hospitalised ITP episodes to MMR vaccine records, we used the self-control case-series method to assess the relative incidence in the 6-week period post vaccination. We also assessed the risk of ITP after dose 2 in those who had ITP after dose 1. We found an increased risk of ITP after dose 1 (relative incidence 2.38 (95% CI: 2.12-2.67)) with an attributable risk of 1 in 42,900 doses. We found no evidence of an increased risk after dose 2 (relative incidence 0.96 (95% CI: 0.81-1.13)). Furthermore, we found that the 336 children with ITP after dose 1 who had MMR dose 2 had no increased risk in the 6-weeks after this dose and that it is therefore safe to vaccinate these children. **Keywords:** Attributable risk; Idiopathic thrombocytopenic purpura; MMR vaccine; Self-controlled case-series; Vaccine safety. Crown Copyright © 2026. Published by Elsevier Ltd. All rights reserved. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. ## Similar articles * [ Vaccines for measles, mumps, rubella, and varicella in children. ](https://pubmed.ncbi.nlm.nih.gov/32309885/) Di Pietrantonj C, Rivetti A, Marchione P, Debalini MG, Demicheli V.Di Pietrantonj C, et al.Cochrane Database Syst Rev. 2020 Apr 20;4(4):CD004407. doi: 10.1002/14651858.CD004407.pub4.Cochrane Database Syst Rev. 2020.Update in: [Cochrane Database Syst Rev. 2021 Nov 22;11:CD004407. doi: 10.1002/14651858.CD004407.pub5.](https://pubmed.ncbi.nlm.nih.gov/34806766/)PMID: 32309885Free PMC article.Updated. * [ Vaccines for measles, mumps and rubella in children. ](https://pubmed.ncbi.nlm.nih.gov/22336803/) Demicheli V, Rivetti A, Debalini MG, Di Pietrantonj C.Demicheli V, et al.Cochrane Database Syst Rev. 2012 Feb 15;2012(2):CD004407. doi: 10.1002/14651858.CD004407.pub3.Cochrane Database Syst Rev. 2012.Update in: [Cochrane Database Syst Rev. 2020 Apr 20;4:CD004407. doi: 10.1002/14651858.CD004407.pub4.](https://pubmed.ncbi.nlm.nih.gov/32309885/)PMID: 22336803Free PMC article.Updated. * [ Vaccines for measles, mumps, rubella, and varicella in children. ](https://pubmed.ncbi.nlm.nih.gov/34806766/) Di Pietrantonj C, Rivetti A, Marchione P, Debalini MG, Demicheli V.Di Pietrantonj C, et al.Cochrane Database Syst Rev. 2021 Nov 22;11(11):CD004407. doi: 10.1002/14651858.CD004407.pub5.Cochrane Database Syst Rev. 2021.PMID: 34806766Free PMC article. * [ MMR vaccine and idiopathic thrombocytopaenic purpura. ](https://pubmed.ncbi.nlm.nih.gov/12534647/) Black C, Kaye JA, Jick H.Black C, et al.Br J Clin Pharmacol. 2003 Jan;55(1):107-11. doi: 10.1046/j.1365-2125.2003.01790.x.Br J Clin Pharmacol. 2003.PMID: 12534647Free PMC article. * [ A new method for active surveillance of adverse events from diphtheria/tetanus/pertussis and measles/mumps/rubella vaccines. ](https://pubmed.ncbi.nlm.nih.gov/7619183/) Farrington P, Pugh S, Colville A, Flower A, Nash J, Morgan-Capner P, Rush M, Miller E.Farrington P, et al.Lancet. 1995 Mar 4;345(8949):567-9. doi: 10.1016/s0140-6736(95)90471-9.Lancet. 1995.PMID: 7619183 [ See all similar articles ](https://pubmed.ncbi.nlm.nih.gov/?linkname=pubmed_pubmed&from_uid=42771940) ## 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