Injury Guide
ITP (Immune Thrombocytopenia) and Thrombocytopenic Purpura
A low platelet count that can cause easy bruising and bleeding. Thrombocytopenic purpura is on the Table for measles-containing vaccines such as MMR.
By VaccineInjuries.org Editorial Team · Last reviewed
Good to know: ITP after vaccination is rare. The National Heart, Lung, and Blood Institute notes that vaccines such as MMR rarely raise the risk of ITP, and lists infections, certain medicines, and other immune conditions among other risk factors.
This guide is general information, not medical or legal advice. If you have symptoms, please talk to a doctor.
What is ITP?
Immune thrombocytopenia (ITP) is a condition in which the immune system destroys platelets, the blood cells that help blood clot. With too few platelets, a person may bruise easily or have trouble stopping bleeding (NHLBI).
NHLBI lists several factors that can raise the risk of ITP, including viral or bacterial infections, certain medicines, other immune conditions, and vaccines such as MMR, which rarely raise the risk, especially in children. Acute ITP in children often goes away on its own within a few weeks or months. Chronic ITP, which lasts 12 months or longer, mostly affects adults.
The Vaccine Injury Table uses the term thrombocytopenic purpura rather than "ITP," and it has its own definition, described below.
Typical symptoms
- Tiny red or purple dots on the skin (petechiae)
- Easy or unexplained bruising
- Nosebleeds or bleeding gums
- Blood in urine or stool, or unusually heavy menstrual periods
- Some people have no symptoms and the low platelet count is found on a blood test
When symptoms typically start
For a Table claim after a measles-containing vaccine, the first symptom must begin 7 to 30 days after vaccination (the exact wording is below).
Is ITP on the Vaccine Injury Table?
Yes, for one vaccine category. Thrombocytopenic purpura is listed on the Vaccine Injury Table for vaccines containing measles virus:
| Vaccine | Time period for first symptom |
|---|---|
| Vaccines containing measles virus (e.g., MMR, MM, MMRV) | 7-30 days (not less than 7 days and not more than 30 days). |
“This term is defined by the presence of clinical manifestations, such as petechiae, significant bruising, or spontaneous bleeding, and by a serum platelet count less than 50,000/mm3 with normal red and white blood cell indices.”— 42 CFR 100.3(c)
- The Table definition excludes thrombocytopenia from other causes, and it excludes immune thrombocytopenic purpura "mediated, for example, by viral or fungal infections, toxins or drugs."
- If a bone marrow exam is done, it must show a normal or increased number of megakaryocytes in an otherwise normal marrow.
- After vaccines that don't contain measles virus, thrombocytopenic purpura is not on the Table. A claim would be off-Table and would need proof of causation.
New to these terms? Read the difference between Table and off-Table injuries.
Filing deadlines
Both federal programs have strict deadlines. Missing one can end a claim, even a strong one, so it helps to write down key dates early.
VICP (most routine vaccines)
- Injury claims: generally within 3 years after the first symptom or manifestation of onset or of the significant aggravation of the injury.
- Death claims: within 2 years of the death and within 4 years of the first symptom of the injury that led to the death.
- Table changes: if the Vaccine Injury Table is changed in a way that newly covers an injury, a claim may be filed within 2 years of the change for injuries up to 8 years before it.
CICP (COVID-19 vaccines and other countermeasures)
- Generally within 1 year of the date the vaccine or other covered countermeasure was given.
- HRSA notes that a letter of intent can be submitted to help meet the deadline while records are gathered.
- The CICP does not pay attorneys' fees.
Severity requirement (VICP):the effects of the injury generally must have lasted more than 6 months, or resulted in inpatient hospitalization and surgical intervention, or resulted in death. Reporting a reaction to VAERS is not the same as filing a claim. See HRSA's VICP eligibility rules and CICP filing process, or our guide to vaccine injury filing deadlines.
Records that matter
You don't need to have everything gathered before asking questions. These are the records that typically help show what happened and when:
- Vaccination record showing which vaccine was given and when
- Complete blood counts (CBC) showing platelet counts over time
- Blood smear and other lab results
- Hematology (blood specialist) notes and treatment records
- Records of any recent illness or new medications before symptoms began
- Follow-up records showing how long the low platelet count lasted
Frequently asked questions
Is ITP on the Vaccine Injury Table?
The Table lists thrombocytopenic purpura for vaccines containing measles virus, such as MMR and MMRV, when it begins 7 to 30 days after vaccination. The Table definition requires a platelet count below 50,000/mm3 and excludes cases caused by other conditions, including ITP triggered by viral infections, toxins, or drugs.
What about ITP after other vaccines?
For vaccines that don't contain measles virus, thrombocytopenic purpura is not on the Table, so a claim would be off-Table and would need proof that the vaccine caused it.
My child's ITP went away in a few months. Is there still a claim?
The VICP generally requires that the effects of an injury last more than six months, result in inpatient hospitalization and surgical intervention, or result in death. NHLBI notes that ITP in children often goes away within weeks or months, so the full course of the condition matters.
What records matter most?
Platelet counts over time, hematology notes, and records showing whether there was a recent infection or new medication, along with the vaccination record showing which vaccine was given and when.
Related articles
Sources
Official regulations and government health sources used for this guide:
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