HPV Vaccines and Idiopathic Thrombocytopenic Purpura

SaneVax-Featured

By Norma Erickson

Kirstie was only 12 years old when she was diagnosed with a rare disorder for which there is no known cure, Idiopathic Thrombocytopenic Purpura (ITP). This happened just a little over a month after her second injection of Gardasil. She will live with this disorder for the rest of her life. Unfortunately, she is not alone.

Gardasil and Cervarix are two of the 76 FDA approved vaccines included in the VAERS (Vaccine Adverse Event Reporting System) database. Since Gardasil was approved for use in the United States, there have been 694 reports of ITP after vaccine administration. 127 of these reports occurred after HPV vaccines. If all vaccines carried equal risk, there should only be 18 reports of Idiopathic Thrombocytopenic Purpura after HPV vaccine use. Why are reports of ITP after Gardasil and Cervarix seven times that amount?

How rare is ITP?

When disease incidence rates are quoted, it is almost always in the context of number of cases per 100,000 people. This is not the case with ITP.

According to the Medscape reference library, the incidence rates for ITP are as follows:

  • United States – adults – 66 cases per 1,000,000 per year
  • United States – children – 50 cases per 1,000,000 per year
  • Denmark and England – 10 to 40 cases per 1,000,000 per year
  • Kuwait – 125 cases per 1,000,000 per year

Idiopathic thrombocytopenic purpura is such a rare disorder that a diagnosis is rendered only after all other possible conditions that could cause purpura have been eliminated. This is called a ‘diagnosis of exclusion’. How many young people are living with undiagnosed ITP after HPV vaccine administration?

What is ITP?

Idiopathic simply means ‘of unknown origin.’ Frequently the word ‘immune’ is substituted for ‘idiopathic’ when referring to ITP because of the antibodies generated to specific platelet membrane proteins that cause the person’s immune system to attack their own platelets.

Thrombocytopenia is the medical term for a low blood platelet count. Platelets (thrombocytes) are minute, disk shaped particles in the blood that promote clotting. When an injury causes a blood vessel to break, the platelets are activated causing them to become spiny. The resulting ‘spines’ allow them to stick to each other and the broken blood vessel walls to begin the clotting process. The normal amount of platelets circulating in a person’s blood ranges from 150,000 to 450,000 per micro-liter. When the blood platelet count falls below 20,000 the thrombocytopenia can cause excessive internal bleeding.

Purpura refers to purple-colored spots and patches that occur on the skin, organs, and in mucus membranes, including the lining of the mouth. Purpura is caused by internal bleeding from small blood vessels.

In short, idiopathic thrombocytopenic purpura is an autoimmune disorder caused by immunoglobulin G (IgG) auto-antibodies on the platelet surface. The number of circulating platelets is reduced due to increased destruction resulting in internal bleeding of varying degrees. ITP in children most commonly occurs following an infection, or occasionally following immunisation. Acute (sudden onset) ITP often resolves spontaneously within a few months. When ITP persists longer than 6 months without specific cause, the condition is considered chronic.

What are the symptoms of ITP?

Simply having a low platelet count does not cause symptoms. However, the bleeding that a low platelet count can cause may have the following signs:

  • Pinpoint red spots on the skin, often found in groups that may look like a rash, caused by bleeding under the skin.
    Petechiae-Purpura

    Petechiae-Purpura

    These spots are called petechiae (see photo on the right).

  • Bruising or purplish areas (purpura) on the skin or mucous membranes caused by bleeding under the skin. (photo on the right)
  • More excessive bleeding can cause hematomas. A hematoma is a collection of clotted or partially clotted blood under the skin that feels like a lump. (photo lower right)
  • Nosebleeds, bleeding from the gums or excessive bleeding after injury.
  • Menstrual bleeding that is heavier than usual.
  • Some people experience untoward, otherwise unexplained fatigue when their platelet count is under 10,000/microl.
  • Hemorrhage is the most serious potential complication, intracranial (within the skull) being the most significant. (Note: the risk for major bleeding in otherwise healthy people is great only when the platelet count is less than 10,000/microl.)
  • Bleeding in the brain is rare. Symptoms of bleeding in the brain include:
    Hematoma

    Hematoma

    • Sudden severe headaches, seizures with no previous history of seizures, weakness in arm(s) or leg(s), nausea or vomiting, decreased alertness, lethargy, changes in vision, tingling or numbness, difficulty speaking or understanding speech, difficulty swallowing, difficulty reading or writing, loss of fine motor skills (such as hand trembling), loss of coordination, loss of balance, abnormal sense of taste, or loss of consciousness. (Note: many of these symptoms are often caused by other conditions.)

A diagnosis of ITP is at the very least a life changing event. Worst case scenario, it can be life threatening. Kirstie from Lima NY, now 18 years of age, is one of the lucky ones. Her diagnosis of ITP after Gardasil changed her life, but she made the most of those changes. There are others who may not have been so fortunate.

18.5% of the ITP reports in the VAERS database since the time Gardasil and Cervarix were approved for use occurred after HPV vaccinations. There are at least 126 families whose lives have been changed, perhaps forever. No one knows how many others are either undiagnosed or unreported.

Admittedly, a VAERS report does not prove causation. The problem with that line of thinking is that cause will never be established if no one looks for it.

What can you do?

Do some research if you are a considering HPV vaccination. Understand the potential risks associated with Gardasil and Cervarix as well as the potential benefits. Decide for yourself whether the potential benefits outweigh the potential risks. No one knows your family’s medical history better than you.

If you have been vaccinated with either Gardasil or Cervarix, be aware that ITP is a possibility. Don’t panic, simply be vigilant. Talk to your medical provider if you are experiencing unusual bruising or unexplained rashes.

If you are a medical professional, consider the possibility of ITP when examining patients who exhibit unexplained purpura after administration of HPV vaccines.

If you are a medical consumer, contact the FDA and CDC. Ask them why such a high percentage of ITP reports in the VAERS database occurred after HPV vaccines. Ask them why two vaccines being associated with 18.5% of the ITP reports in VAERS does not raise a red flag. Ask them why they are not ordering studies to determine whether there could be a causal relationship between HPV vaccines and ITP.

 

Comments

  1. MERYL NASS, MD says:

    FDA scientists showed that ITP is also caused by measles vaccine.

    Meryl Nass, mD

  2. Sandy Lunoe says:

    Excellent article.
    The significance of autoimmune disorders is either downplayed or ignored by vaccine manufacturers. Doctors may not link vaccines to autoimmune disorders for many reasons including:
    – Many are not even stated in product information.
    – The disorders may present a long time, even years after vaccination.
    – Doctors’ time and work is involved with little or no reimbursement.
    – Pressure from the industry against reporting adverse reactions.
    – Creative strategies from the industry targeting doctors

    The latter reminds of this article:
    “Farcical Study of Gardasil Safety: Medscape Gives CME Training Credit for It”
    http://gaia-health.com/gaia-blog/2012-02-15/farcical-study-of-gardasil-safety-medscape-gives-cme-training-credit-for-it/
    (- all studies performed by vaccine manufacturers are probably farcical).

    I passed the creative test in which the doctors were invited to participate. I attained credits and a Medscape certificate for participation in the material titled: “Rate of Autoimmune Conditions Not Increased with HPV4 Use”.

    Thrombocytopenia is actually referred to in a couple of studies in the package insert information for both Cervarix and Gardasil (p. 8 and 10 resp).
    Neither study can be taken seriously, one reason being the false placebos:
    The “placebo” used in the Gardasil study is pooled and stated as: “AAH Control or saline placebo”. (AAHS Control = Amorphous Aluminium Hydroxyphosphate Sulfate)
    The “Pooled Control Group” for Cervarix includes Hepatitis A vaccine and aluminium hydroxide.

    These safety studies are also farcical, but the resulting approval of these vaccines has tragic consequences.

  3. Forty-three years ago .. my then four year old daughter .. now mom to three of my five beautiful grandchildren .. was diagnosed with ITP. At that time .. the term “idiopathic” was explained to us as meaning doctors had absolutely no clue as to what “caused” ITP. Not one doctor dared mention that her ITP may have been caused by a vaccine she received. Indeed, it wasn’t until my third grandchild .. a boy .. regressed and was diagnosed autistic .. that I discovered that ITP was among the varied illnesses comprising Gulf War Syndrome and that vaccines were suspected as being a causative factor.

    Okay .. they absolutely refuse to do a “vaccinated v. unvaccinated” study because it would be supposedly “unethical” to do so. What stops them from doing a study comparing vaccinated children diagnosed with ITP .. with unvaccinated children also diagnosed with ITP? In other words .. are vaccinated children more likely to suffer ITP than unvaccinated children? Inquiring minds would like to know.

    • Excellent suggestion. Inquiring minds would indeed like to know. “Informed consent” requires having information – all of the information.

    • Inquired mind says:

      “are vaccinated children more likely to suffer ITP than unvaccinated children?“

      You don’t necessary need a vaccinated vs unvaccinated study to have a correct idea of the answer, because the rates of some events are known through observations and/or studies. For instance:
      – the expected incidence of measles and rubella in an unvaccinated population corresponding to the actual US population (almost 3 000 000 cases per year for each of the disease)
      – the actual incidence of measles and rubella in US (almost 0)
      – the number of persons annually immusized against measles and rubella (almost 3 000 000)
      – the rate of TP following measles and rubella (of the order of 1 for 1000 cases, for both measles and rubella)
      – the rate of TP following MMR immusisation (of the order of 1/30 000 child)
      Then,
      for the vaccinated US: 3 000 000*(1/30 000)=100 ITP (almost none are reported to VAERS)
      for the unvaccinated US: 3 000 000*(1/1000)*2=6000 ITP
      So vaccinated children are less likely to suffer TP than unvaccinated children, in the context of measles and rubella.

      Regards

      • References, please?

        • Inquired mind says:

          Sure.

          – Incidence of almost 3 000 000 cases per year for each of the disease:

          Before the vaccination era (and so would be the case today without vaccine) almost everyone got measles [1]. This means that the mean annual incidence equals the mean annual birth rate [2]. This is true for any country and also for rubella [3].

          -the actual incidence of measles and rubella in US (almost 0):

          222 reported measles cases in 2011 [4], negligible in front of the average 500 000 reported (yes, only 1 case out of 6 has been reported …) cases before vaccination [5]. Rubella has also been almost eliminated in US by the vaccine [6].

          -the number of persons annually immunized against measles and rubella (almost 3 000 000):

          Nearly all children will have the MMR, therefore you also need to use the mean annual birth rate, or about 3 000 000.

          -the rate of TP following measles and rubella (of the order of 1 for 1000 cases, for both measles and rubella):

          I read this on a French written website [8]. You can also find that “Thrombocytopenia occurs at a ratio of 1 per 3,000 cases and is more likely to affect children”. Blood disorders occur also after measles, at an even higher rate than after rubella [9].

          – the rate of TP following MMR immunization (of the order of 1/30 000 child):

          Quoted from [10]:
          “The most frequent complication requiring hospitalization was acute thrombocytopenic purpura, which occurred at a rate of 3.3 per 100,000 vaccinated persons.”
          (3.3/100 000, or 1/30 000)

          And to conclude [11]:

          “[…] administration of MMR vaccine is justified because of the even greater risk for thrombocytopenia after measles or rubella disease.”

          [1] http://www.cdc.gov/vaccines/vac-gen/whatifstop.htm
          [2] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1646302/
          [3] http://www.ncbi.nlm.nih.gov/pubmed/14613687
          [4] http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6115a1.htm?s_cid=mm6115a1_w
          [5] http://upload.wikimedia.org/wikipedia/commons/e/ed/Measles_US_1944-2007_inset.png
          [6] https://upload.wikimedia.org/wikipedia/commons/7/7a/Rubella-us-1966-93-cdc.gif
          [7] http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6034a2.htm
          [8] http://www.infovac.fr/index.php?option=com_content&view=article&id=133&Itemid=149
          [9] http://www.ncbi.nlm.nih.gov/pubmed/7247494
          [10] http://sanevax.org/hpv-vaccines-and-idiopathic-thrombocytopenic-purpura/#comment-5122
          [11] http://www.cdc.gov/vaccines/pubs/pinkbook/meas.html#complications

          • Thank you! The French website you quoted for the statement “-the rate of TP following measles and rubella (of the order of 1 for 1000 cases, for both measles and rubella): I read this on a French written website [#8]. is actually referring to the incidence of TP after MMR vaccinations.
            The second reference you provided to corroborate that statement [#9] was referring to subclinical TP, subclinical means presenting no symptoms – although it was an incident report of TP after measles/rubella disease – all ‘cases’ were simply laboratory confirmed low-platelet count with a spontaneous return to normal platelet level after the disease had run its course. Respectfully, this is like comparing apples and oranges to reach a conclusion. The CDC reference

          • http://www.cdc.gov/vaccines/pubs/pinkbook/meas.html#pathogenesis
          • actually says:

            Persons who have a history of thrombocytopenic purpura or thrombocytopenia (low platelet count) may be at increased risk for developing clinically significant thrombocytopenia after MMR vaccination. No deaths have been reported as a direct consequence of vaccine-induced thrombocytopenia. The decision to vaccinate with MMR depends on the benefits of immunity to measles, mumps, and rubella and the risks for recurrence or exacerbation of thrombocytopenia after vaccination or during natural infection with measles or rubella. The benefits of immunization are usually greater than the potential risks, and administration of MMR vaccine is justified because of the even greater risk for thrombocytopenia after measles or rubella disease. However, deferring a subsequent dose of MMR vaccine may be prudent if the previous episode of thrombocytopenia occurred within 6 weeks after the previous dose of the vaccine. Serologic evidence of measles immunity in such persons may be sought in lieu of MMR vaccination.

            The same document lists the complications from measles, which occur in 30% of diagnosed cases as: diarrhea (8%), otitis media (7%), pneumonia (6%), seizures (0.6-0.7%) encephalitis (0.1%) and death (0.2%). Nowhere in the rest document is there a reference to the risk of TP following either measles or rubella.

  • Inquired mind says:

    You’re welcome. I’m afraid I wasn’t clear enough.

    -The French website is saying that TP occurs at a rate of 1/30 000 after MMR vaccination, against 1/1000 after the disease.
    -I forgot the reference http://www.cdc.gov/mmwr/preview/mmwrhtml/00053391.htm
    for the statement “that Thrombocytopenia occurs at a ratio of 1 per 3,000 cases and is more likely to affect children” which is referring to rubella.
    -My point with reference [9] was that if subclinical TP (I talked about blood disorder and not TP because I was aware it was not TP… ) is observed after 30% of the natural rubella cases, and 55% of the measles case, one wouldn’t be surprise to have a rate of clinical TP similar (or even slightly higher) after measles than after rubella. This deduction is consistent with the French Website and the CDC reference which says that the risk for thrombocytopenia after measles or rubella disease is greater that after MMR vaccine.

  • My daughter has ITP months from Gadisil. Been going on for three years. She’s hospitol

  • This reference might be useful:
    http://www.ncbi.nlm.nih.gov/pubmed/22232308
    “The risk of immune thrombocytopenic purpura after vaccination in children and adolescents.”
    It was done in 2012, and included HPV vaccine in its analysis.

  • My daughter’s platelet count fell to dangerously low levels less than a week following her first Gardisil vaccination. She was then diagnosed with ITP.
    I questioned the vaccine to the medical experts prior to and was reassured, in fact a bit scoffed at that I even considered NOT letting her get it. Yes, Cancer is a horrible disease however anybody who has had to live with ITP knows how serious a condition it is. The treatments can be painful, invasive and it is life changing.
    In retrospect, I wish I had trusted my own gut feeling and saved my daughter the years of infusions, high dose steroids, auto-immune drugs, and a splenectomy. If you are aware that a family member is in any way genetically pre-disposed to Auto-immune diseases, please take the time and do the research, as I did not and pay my child is paying the price for my negligence.

  • Hi Teri…
    How old was your daughter when she was diagnosed with ITP? And how is she doing now. I have a 6 years daughter that was diagnosed right before her 3rd birthday. She has had a bone marrow scrape, many rounds of IVIG, taken steroids and just frequently is taking dapsone. What is the right thing to do? How I wish there was something that would fix my little girls platelets.

  • Speak Your Mind

    *

    *