Association Between Influenza Vaccine and Immune Thrombocytopenia: A Systematic Review and Meta-Analysis

Background: Immune thrombocytopenia (ITP) is an uncommon but serious adverse reaction after vaccination. However, its association with vaccines other than the measles–mumps–rubella vaccine remains debatable. This study aimed to analyze ITP cases following influenza vaccination and assess any potenti...

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Main Authors: Zhicai Liu, Jing Wang, Zhaojun Lu, Yuyang Xu, Jian Du, Jiayin Han, Xuechao Zhang, Yan Liu
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Vaccines
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Online Access:https://www.mdpi.com/2076-393X/12/11/1298
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author Zhicai Liu
Jing Wang
Zhaojun Lu
Yuyang Xu
Jian Du
Jiayin Han
Xuechao Zhang
Yan Liu
author_facet Zhicai Liu
Jing Wang
Zhaojun Lu
Yuyang Xu
Jian Du
Jiayin Han
Xuechao Zhang
Yan Liu
author_sort Zhicai Liu
collection DOAJ
description Background: Immune thrombocytopenia (ITP) is an uncommon but serious adverse reaction after vaccination. However, its association with vaccines other than the measles–mumps–rubella vaccine remains debatable. This study aimed to analyze ITP cases following influenza vaccination and assess any potential association. Methods: We performed a systematic search of the Web of Science, Embase, and PubMed databases from their inception to 15 April 2024. Cases were characterized qualitatively, and relative risk was assessed using either fixed or random models. Results: A total of 24 studies were analyzed, including 16 patients from 14 case reports. Patients averaged 56.7 years old, half were female, and ten patients had a history of prior illness. The mean time between vaccination and diagnosis was 13.3 days. Treatment primarily involved corticosteroids or intravenous immunoglobulin, with most recovering within a month. The pooled odds ratio for ITP post-influenza vaccination was 0.94 (95%CI: 0.85–1.03). Subgroup analyses conducted according to the study design and vaccine type did not reveal any significant results. Conclusion: No evidence of an association between influenza vaccination and ITP was found. Further observational studies are required to verify this relationship.
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series Vaccines
spelling doaj-art-7ce93135cac54ceaaccc87e8328c14fe2025-08-20T02:04:44ZengMDPI AGVaccines2076-393X2024-11-011211129810.3390/vaccines12111298Association Between Influenza Vaccine and Immune Thrombocytopenia: A Systematic Review and Meta-AnalysisZhicai Liu0Jing Wang1Zhaojun Lu2Yuyang Xu3Jian Du4Jiayin Han5Xuechao Zhang6Yan Liu7Department of Public Health, Medical School of Ningbo University, Ningbo 315211, ChinaDepartment of Infectious Disease Control and Prevention, Hangzhou Center for Diseases Control and Prevention (Hangzhou Health Supervision Institution), Hangzhou 310021, ChinaDepartment of Expanded Program on Immunization, Hangzhou Center for Diseases Control and Prevention (Hangzhou Health Supervision Institution) Hangzhou 310021, ChinaDepartment of Expanded Program on Immunization, Hangzhou Center for Diseases Control and Prevention (Hangzhou Health Supervision Institution) Hangzhou 310021, ChinaDepartment of Expanded Program on Immunization, Hangzhou Center for Diseases Control and Prevention (Hangzhou Health Supervision Institution) Hangzhou 310021, ChinaDepartment of Expanded Program on Immunization, Hangzhou Center for Diseases Control and Prevention (Hangzhou Health Supervision Institution) Hangzhou 310021, ChinaDepartment of Expanded Program on Immunization, Hangzhou Center for Diseases Control and Prevention (Hangzhou Health Supervision Institution) Hangzhou 310021, ChinaDepartment of Expanded Program on Immunization, Hangzhou Center for Diseases Control and Prevention (Hangzhou Health Supervision Institution) Hangzhou 310021, ChinaBackground: Immune thrombocytopenia (ITP) is an uncommon but serious adverse reaction after vaccination. However, its association with vaccines other than the measles–mumps–rubella vaccine remains debatable. This study aimed to analyze ITP cases following influenza vaccination and assess any potential association. Methods: We performed a systematic search of the Web of Science, Embase, and PubMed databases from their inception to 15 April 2024. Cases were characterized qualitatively, and relative risk was assessed using either fixed or random models. Results: A total of 24 studies were analyzed, including 16 patients from 14 case reports. Patients averaged 56.7 years old, half were female, and ten patients had a history of prior illness. The mean time between vaccination and diagnosis was 13.3 days. Treatment primarily involved corticosteroids or intravenous immunoglobulin, with most recovering within a month. The pooled odds ratio for ITP post-influenza vaccination was 0.94 (95%CI: 0.85–1.03). Subgroup analyses conducted according to the study design and vaccine type did not reveal any significant results. Conclusion: No evidence of an association between influenza vaccination and ITP was found. Further observational studies are required to verify this relationship.https://www.mdpi.com/2076-393X/12/11/1298Immune thrombocytopeniapurpurainfluenzavaccinationmeta-analysis
spellingShingle Zhicai Liu
Jing Wang
Zhaojun Lu
Yuyang Xu
Jian Du
Jiayin Han
Xuechao Zhang
Yan Liu
Association Between Influenza Vaccine and Immune Thrombocytopenia: A Systematic Review and Meta-Analysis
Vaccines
Immune thrombocytopenia
purpura
influenza
vaccination
meta-analysis
title Association Between Influenza Vaccine and Immune Thrombocytopenia: A Systematic Review and Meta-Analysis
title_full Association Between Influenza Vaccine and Immune Thrombocytopenia: A Systematic Review and Meta-Analysis
title_fullStr Association Between Influenza Vaccine and Immune Thrombocytopenia: A Systematic Review and Meta-Analysis
title_full_unstemmed Association Between Influenza Vaccine and Immune Thrombocytopenia: A Systematic Review and Meta-Analysis
title_short Association Between Influenza Vaccine and Immune Thrombocytopenia: A Systematic Review and Meta-Analysis
title_sort association between influenza vaccine and immune thrombocytopenia a systematic review and meta analysis
topic Immune thrombocytopenia
purpura
influenza
vaccination
meta-analysis
url https://www.mdpi.com/2076-393X/12/11/1298
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