Your blood is more than just red liquid. It contains living tissue, composed of a variety of cells. Erythrocytes (red blood cells) ferry oxygen; leukocytes (white blood cells) attack invasive material. Platelets staunch bleeding by sticking to each other. A nick, a cut, a bruise, and they arrive to form a clot, patching where the blood leaves the vein. Imagine if the water in your faucet solved leaks on its own. That’s almost like what platelets do.
What is Thrombocytopenic Purpura?
Basically, platelets rely on stickiness and numbers to do their job. If their numbers decrease, it becomes harder for your blood to clot. When this happens, “mild to serious bleeding can occur,” says the National Heart Lung and Blood Institute. Thrombocytopenic purpura is the term the Vaccine Injury Compensation Program uses to refer to a collection of symptoms that can result from such deficiencies.
The symptoms may include:
- Purpura (bruising): Bruises are in fact cases of bleeding in the deeper layers of your skin. They get their medical name from the color. (Purpura means purple in Latin.)
- Petechiae: According to the Mayo Clinic, “[p]etechiae are pinpoint, round spots that appear on the skin as a result of bleeding. The bleeding causes the petechiae to appear red, brown or purple.” As this article observes, “petechiae may look like a rash.”
- Bleeding from the nose or gums
- Bloody stools
- Uncontrolled bleeding
In some cases, people suffering from Thrombocytopenic Purpura may experience stroke symptoms.
How many platelets should I have?
Per the National Heart Lung and Blood Institute, adults should have between one hundred fifty thousand and four hundred fifty thousand platelets for every microliter of blood. (For reference, there are twelve fluid ounces in a can of soda. Twelve ounces convert to three hundred fifty-four thousand, eight hundred and eighty-two microliters. That means, a soda can filled with blood from a healthy adult would contain more than six hundred thirty-eight billion platelets.)
Are there different kinds of Thrombocytopenic Purpura?
Very much so. One variety is Immune (or Idiopathic) Thrombocytopenic Purpura (ITP) and another is Thrombotic Thrombocytopenic Purpura (TTP). In the case of ITP the body’s immune system attacks its own platelets, causing the decline in numbers. ITP can result from a variety of causes, including HIV or hepatitis C infections. In rare cases, it has also been linked to the Measles, Mumps, and Rubella (MMR) vaccines.
It’s important to be precise here. Most people, who receive the MMR vaccine suffer no such injury. Nonetheless, people who receive this vaccine do have a higher risk of immune thrombocytopenic purpura. This study found, “[t]he best absolute risk is 1 in 22 300 doses, with two of every three cases being vaccine attributable.” (emphasis added) Another study found a slightly different risk—one in twenty-five thousand. Physicians are not certain what part of the MMR vaccine may cause this risk. To quote from the former article again, “[t]he component of MMR vaccine which is responsible for vaccine associated ITP is uncertain, but both the measles and rubella components are likely candidates.” (footnotes deleted) See also this last study for more information.
Physicians may diagnose ITP with blood smears, complete blood counts, or bone marrow tests. ITP can range from mild to severe cases. Treatment may involve corticosteroids or stopping certain medicines. Some patients receive splenectomies.
Another variety of thrombocytopenic purpura is TTP which happens when blood clots prevent platelets from flowing to where your body needs them. Whereas ITP occurs when your immune system attacks your platelets, TTP occurs thanks to “[a] lack of activity in the ADAMTS13 enzyme (a type of protein in the blood),” per the National Heart Lung and Blood Institute. This may result from a faulty gene or from other causes. Cases of TTP may involve additional side effects, such as paleness or jaundice, a fever, blood in urine, and an increased heart rate. Diagnosing TTP may require more tests than when diagnosing ITP. Your physician might examine your urine, for example. Doctors use plasma therapy to treat TTP.
How does this relate to the Vaccine Injury Compensation Program?
Although most of the time, vaccinations result in no worse than mild side effects, in rare instances significant injuries do occur. If you receive one of the vaccines covered by the program, and suffer an injury, you may be able to pursue a case in vaccine court. If your case qualifies, you can file a vaccine injury claim against the Secretary of Health and Human Services. If you prove your injuries were more likely than not caused by the vaccine, you may be eligible for compensation, drawn from money raised by a seventy-five cent excise tax on all covered vaccines. Even if you do not win compensation, your attorney’s fees may still be covered.
Because studies have linked ITP to the MMR vaccine, the National Vaccine Injury Compensation Program considers it a “table injury,” provided the ITP occurs between seven and thirty days after vaccination. In a table injury the presumption is that the vaccine caused the problem, and the burden of proof rests on the government to show that the injury wasn’t caused by the vaccine. Although ITP is only a table injury for the MMR vaccine, ITP has occurred after receiving other vaccines. When this happens, it is considered a “non-table injury”. Note that non-table injuries may also be eligible for compensation but in that setting the vaccine injured person has the burden of proof to show that the vaccine caused the injury. Other examples of table injuries for the MMR vaccine include anaphylaxis (also called anaphylactic shock), encephalitis, and encephalopathy.