Thomas Whitney, Albano Adam, Kirkel Dean, Rouhizad Nason, Arinze Folasade
Department of Internal Medicine, Wellstar Health System, Marietta, GA, USA.
Northwest Georgia Oncology Centers, P.C Wellstar Health System, Marietta, GA, USA.
Case Rep Infect Dis. 2021 Oct 9;2021:2704249. doi: 10.1155/2021/2704249. eCollection 2021.
We report a case of immune thrombocytopenic purpura (ITP) in an otherwise healthy 31-year-old man following coadministration of the live measles, mumps, and rubella (MMR) vaccine with the Pfizer-BioNTech mRNA SARS-CoV-2 vaccine. The patient was hospitalized briefly and treated for ITP with glucocorticoids, IVIG, and platelet transfusion. Although our patient's clinical presentation and subsequent course are similar to those of other cases of ITP in association with SARS-CoV-2 vaccination, to our knowledge, this is the first reported case of ITP following MMR and mRNA SARS-CoV-2 vaccine coadministration. It would be impossible to conclusively prove that the patient's thrombocytopenia was secondary to the SARS-CoV-2 vaccine alone, the MMR vaccine, or an additive effect of both vaccines. However, with the CDC guidelines recommending the coadministration of the mRNA SARS-CoV-2 vaccine without regards to timing with other vaccines, we urge further caution as there is limited evidence to inform practice. This case highlights the need for further safety data regarding the coadministration and timing of the mRNA SARS-CoV-2 vaccine with other vaccines.
我们报告了一例31岁健康男性在同时接种麻疹、腮腺炎和风疹（MMR）活疫苗与辉瑞- BioNTech mRNA新冠病毒疫苗后发生免疫性血小板减少性紫癜（ITP）的病例。该患者曾短期住院，并接受了糖皮质激素、静脉注射免疫球蛋白（IVIG）和血小板输注治疗ITP。尽管我们患者的临床表现及后续病程与其他与新冠病毒疫苗相关的ITP病例相似，但据我们所知，这是首例MMR疫苗与mRNA新冠病毒疫苗同时接种后发生ITP的报告病例。不可能确凿地证明患者的血小板减少是仅由新冠病毒疫苗、MMR疫苗或两种疫苗的叠加效应所致。然而，鉴于美国疾病控制与预防中心（CDC）指南建议在不考虑与其他疫苗接种时间的情况下同时接种mRNA新冠病毒疫苗，由于为实践提供参考的证据有限，我们敦促进一步谨慎行事。该病例凸显了需要关于mRNA新冠病毒疫苗与其他疫苗同时接种及接种时间的更多安全性数据。
