Assessing the Impact of Rotavirus Vaccination on Idiopathic Thrombocytopenic Purpura in the United States Open Access

Ramaraju, RamyaSre (Spring 2019)

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Rotavirus vaccination has been extremely effective in reducing rotavirus infections in the United States and has had several non-rotavirus impacts. Idiopathic/Immune Thrombocytopenic Purpura (ITP) is a blood disorder that has been linked with Measles Mumps Rubella vaccination in the past and its association with rotavirus vaccination are currently unknown.


The MarketScan Commercial Claims and Encounters Database was utilized to perform a survival analysis on enrollees on the risk of developing ITP based on vaccination status while accounting for covariates such as sex of the enrollee and the enrollee’s geographic region. Of 371,422 enrollees from the 2009 MarketScan birth cohort, 292,566 enrollees were eligible for analysis.


Analysis of the data by vaccination status resulted in a hazard ratio of 1.10 with a 95% confidence interval of (95% CI: 0.48, 2.52). When controlling for sex, the hazard ratio was 1.07 (95% CI: 0.47, 2.46) and upon controlling for region, the hazard ratio was 1.10 (95% CI: 0.48, 2.52). The hazard ratios indicate little difference when controlling for the covariates.


We found no evidence of correlation between rotavirus vaccination and ITP. Additional studies might be required to more conclusively assess the effect of rotavirus vaccination on ITP.

Table of Contents

Table of Contents




Data Source

Identification of ITP and Vaccination Status

Survival Analysis Data Setup

Calculation of Enrollee Age for Survival Analysis

Statistical Analysis


Vaccinated vs. Unvaccinated Enrollees

Enrollees with ITP vs. Enrollees without ITP

Survival analysis by Exposure: Vaccination Status and Potential Confounders: Sex and Region

Testing the Proportional Hazards (PH) Assumption

Log-Log Survival Curves

Goodness of Fit Testing


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