The Garmin-Transitions rider came to grief with about 35km to go on the 224km stage from Amsterdam to Middelburg. Team director Matt White confirmed from the race they suspect Vande Velde has a broken collarbone.
The crash was Vande Velde's second of the race. He fell on stage two, but only suffered a gash to his leg from a chainring.
It is the second year in a row that Vande Velde has crashed out of the Giro d'Italia in the first week. Last year he suffered much more severe injuries, with several fractured vertebrae and broken ribs.
Vande Velde arrived at the finish in Middelburg in a race ambulance and was then taken to the showers, where the rest of the riders were getting ready for the flight to Italy. He sat in the back seat of a team car as the team doctor and staff arranged for him to visit a specialist in Gent, Belgium, so he can quickly undergo an operation if needed.
"Tyler Farrar knows a good guy in Gent. A lot of broken collarbones take place in Belgium, so I'll go over there," Vande Velde told Cyclingnews.
"I knew straight away it was broken. I could feel it moving around. It's quite displaced right now. I need to get it sorted. I know it's broken but I have to see how bad it is and see a specialist."
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Vande Velde crashed after 105km of racing, along with Marzio Bruseghin and Arnold Jeannesson of Caisse d'Epargne. They got back and finished the stage. Just like last year, Vande Velde's Giro was over far too early.
"It's exactly the same day," Vande Velde revealed.
"It was just nervous out there. The guys slam on the brakes and I went into the back wheel of somebody. That's about it."
"I'm not going to lie. It's really hard to take right now. Especially before the team time trial. I was really motivated and really wanted to get Dave (Millar) into the pink jersey. They definitely still can do it but I really wanted to be a part of it."
