Convince me the chicken pox vaccine isn't stupid

[CairoCarol]

@amanset

This.

I am thirty seven and have not had chicken pox. Infected kids scare me. The less infected kids there are the easier my peace of mind and the lower my likelihood of getting what is apparently a nasty illness.

So why not get the vaccine? Adults can get it too.

[Yllaria]

@CairoCarol

. . . If you have the vaccine as a kid, it seems as if you are increasing the likelihood you will get chicken pox as an adult, and chicken pox in adults is worse. . .

I’ve only got an anecdote, but I don’t think that’s the way it work. See, I took a vaccine that didn’t work, only it was the rubella one. I don’t know how old I was when I got it the first time, but I know I was in school. Mom had us get it as soon as it came out.

They test for rubella antibodies when you get pregnant, though, and I didn’t have any. So after my first was born, I got another vaccine. Then I was pregnant with my second and, again, no antibodies. That was less than three years after the second vaccine. So I got a third vaccine.

My third pregnancy started less than a year after the second. Still no antibodies. At that point I smiled and nodded and didn’t bother getting the shot. My conclusion was that for some people the vaccine just doesn’t work. If I wasn’t produding antibodies a year after the vaccine, I just wasn’t producing antibodies.

I think the odds are good that your son was never immune to chicken pox and that he could have caught it younger but just didn’t. Now, possibly he didn’t catch it because there were fewer other kids to catch it from, and that’s the vaccine’s fault. But I don’t think the vaccine delayed his vulnerability directly.

[Mosier]

@CairoCarol

So why not get the vaccine? Adults can get it too.

The vaccine not only works by giving him (her?) a good chance at personal immunity, but also reducing the number of infected kids he encounters if his vaccine happens to fail!

[FrillyNettles]

@Broomstick

Since the vaccine contains no live virus the vaccine can NOT give you shingles!

It’s getting chicken pox that puts you at risk for shingles.

Incorrect. The varicella vaccine is a modified live virus vaccine. My youngest daughter received this vaccine at the age of 15 months. She developed shingles at the age of 4. However, it was a very mild case of shingles. She had never had the actual virus, so she had to have developed shingles in response to the vaccine.

Because she has had severe reactions to another live virus vaccine, her neurologist does not want her to have the booster for varicella. This worries me, as I don’t want her immunity to wear off, leaving her vulnerable as an adult. However, her doctor checked her titer at the age of 15, and she still had a very high titer from the one vaccine she received as a toddler.

BTW, people who have natural chicken pox infections can still get re-infected. It all depends on how your immune system reacted to the first infection. I know a woman who has had natural chicken pox THREE separate times. Yet my daughter, who had one vaccine at the age of 15 months, had a high vaccine titer at the age of 15. So who knows.

But you CAN still get shingles. She did.

[DSeid]

@Broomstick

Since the vaccine contains no live virus the vaccine can NOT give you shingles!

Indeed that is incorrect. It is a live weakened virus. One can get shingles after it. Experience with high risk childrenhas demonstrated that the risk is much less after the vaccine than from natural disease however.

As for data on the vaccine’s overall benefit - I refer to this recent study.

Near Elimination of Varicella Deaths in the US After Implementation of the Vaccination Program … During the 12 years of the mostly 1-dose US varicella vaccination program, the mortality rate attributed to varicella as the underlying cause declined by 88% compared with the prevaccine years. The decline occurred in all age groups, with an extremely high reduction among children and adolescents younger than 20 years (97%) and among those younger than 50 years overall (96%). Most of the deaths (89%) continued to occur among those without apparent contraindications to vaccination and were therefore potentially preventable. … we found a greater-than-expected decline (67%) in mortality with varicella listed as an underlying cause of death among adults aged 50 years or older …

Hospitalizations assciated with varicella have also been drastically reduced.

I was a skeptic when it came out, and I still have some concerns, but so far it is proving itself to have been a very good idea.

[Cazzle]

In the last 5 years two children of acquaintances have had shingles, even though shingles is apparently very rare in the under 10 age group. I have wondered if there’s a connection to the chicken pox vaccine, but haven’t been in a position to ask (both were friends of a friend, and neither friend knew for sure if the child had been vaccinated).

[Implicit]

@Cazzle

In the last 5 years two children of acquaintances have had shingles, even though shingles is apparently very rare in the under 10 age group. I have wondered if there’s a connection to the chicken pox vaccine, but haven’t been in a position to ask (both were friends of a friend, and neither friend knew for sure if the child had been vaccinated).

Your anecdote isn’t particularly enlightening.

"very rare? Not really, 5% of shingles cases are in children.

[Eva_Luna]

@DSeid

Indeed that is incorrect. It is a live weakened virus. One can get shingles after it. Experience with high risk childrenhas demonstrated that the risk is much less after the vaccine than from natural disease however.

As for data on the vaccine’s overall benefit - I refer to this recent study.
Hospitalizations assciated with varicella have also been drastically reduced.

I was a skeptic when it came out, and I still have some concerns, but so far it is proving itself to have been a very good idea.

Out of curiosity (and I will ask my doc about it when I go for my next appt.), my sister was very surprised to be diagnosed with shingles last year, as to the best of Mom’s recollection, neither of us ever had chickenpox, and the vaccine didn’t exist yet when we were at the regular age to get it. I should look into getting it now, no? (She was diagnosed literally days after my annual checkup last year.) We both had all kinds of rashes, etc. as a kid, and at least my sister must have had chickenpox at some point then, right? Which means I may have, too, without realizing it?

P.S. *A propos *of nothing, we had a pediatric dermatologist named Dr. Spot, to whom we were referred by our pediatrician, Dr. Gerber.

[CairoCarol]

@DSeid

As for data on the vaccine’s overall benefit - I refer to this recent study.
Hospitalizations assciated with varicella have also been drastically reduced.

I was a skeptic when it came out, and I still have some concerns, but so far it is proving itself to have been a very good idea.

Thank you! That is precisely the sort of information I was looking for when I started this thread. (I suppose I could have put the question in GQ, but I was concerned that that data might be preliminary/open to interpretation, so I choose IMHO - also that’s where medical stuff goes, so I hope I made the right choice.)

[Motorgirl]

I recently had myself tested for chicken pox immunity. I figured that at the age of 40 I needed to get immunized if I wasn’t immune. My sister had chicken pox when I was 7, and despite my mom’s best efforts (keeping me home from school to hang out with my sister) I never had noticeable chicken pox. I say noticeable because the blood test showed I did have chicken pox at some point. My mom swore I never had it, though, because I never had a fever, no pox, nothing.

[Rushgeekgirl]

It’s a required immunization to get into my community college. My daughter got her first shot just yesterday and has to go back again in a month for the second dose. What stinks is she had chicken pox as a child but I didn’t have proof and it costs 150 for the titer test but only 13 for the shot so she chose to get the shot.

[Cazzle]

@Implicit

Your anecdote isn’t particularly enlightening.

"very rare? Not really, 5% of shingles cases are in children.

Anecdotes are rarely enlightening. They’re just stuff that happened. At the time I Googled for links between the vaccine and shingles and found absolutely nothing so I chalked it up to coincidence but am watching with interest to see if a link emerges as the duration the vaccine has been in use lengthens. My daughter received the vaccination recently - I’m not making decisions based on this anecdotal information, I was just surprised to hear of two separate children with shingles when that was rare enough that every time it’s been discussed, the majority believed children don’t get shingles.

[mnemosyne]

Health Canada has a pretty good information page on the varicella-zoster (shingles) vaccine, it’s observed efficiency and areas identified as additional long-term research.

Here’s the link… I’ll leave it to you to read it; there is a LOT of information there!

Note, with regards to herpes zoster (shingles) it says (among other facts):

Herpes zoster after vaccination:

Varivax® III:
During > 84 400 person-years of follow-up of children vaccinated with Varivax® 12 cases of herpes zoster were reported, corresponding to a rate of 14 cases/100 000 person-years.
This compares with a herpes zoster rate of 68/100 000 among healthy children after wild-type varicella infection(46).

In adolescents and adults, two cases of herpes zoster occurred during > 12 300 person-years of follow-up, for a rate of 16 cases/ 100 000 person-years. Herpes zoster secondary to varicella vaccination was mild, and there were no serious sequelae(47,48).

Varilrix®
The above-mentioned Canadian study reported herpes zoster in three of the 431 study participants (0.7%)(44,45). The average zoster rate after immunization was 7.7 per 10 000 child- months of observation.

(The data is for two separate forms of the vaccine made by MerckFrosst and GlaxoSmithKline respectively, and is originally in a table, so I’ve done some minor formatting to the quote to clarify the data - no editing of the text itself was done)
Also:

In the United States, local surveillance programs have so far not detected any appreciable rise in adult zoster rates in Seattle, Washington (data available for 1992-2001) or in Massachusetts (a less sensitive system, with data from 1998-2000). Zoster rates are also being monitored in Antelope Valley, California, and preliminary results for 2000-01 have not shown an increase among adolescents(72). However, it may be too early to detect an increase in zoster rates, and ongoing surveillance is necessary (A. Jumaan, Centers for Disease Control and Prevention, Atlanta: personal communication). At the present time, the theoretical risk of increased zoster occurring in the adult population is not a reason for withholding the vaccination of children. Surveillance for zoster cases should be continued in order to detect whether this risk materializes. If it does, the best intervention would be to immunize adults rather than to stop vaccinating children. Vaccination itself has the added benefit of reducing the risk of herpes zoster in the recipient (see Table 1). For example, studies using the live vaccine in immunocompromised children with leukemia and the inactivated vaccine in adult recipients of hematopoietic transplants have demonstrated 67% and 60% reductions respectively in the risk
of zoster(73,74).

Bolding mine.

There are also comments on herd immunity and on relative severity of chickenpox infection after the vaccine compared to after exposure to wild-type. Really, the data is pretty convincing.

[CairoCarol]

Thanks mnemosyne - that too is a very helpful post.

[chela]

Hopefully his is a mild case.

My kids had the varicella vax as preschoolers. They also had to get a varicella booster shot in middle school.

I’ve had CP as a kid. I’ve been told my occassional itchy rashes may not be poison ivy but shingles:eek:

[DSeid]

Implicit in mnemosyne’s post is an acknowledgement that what Zsofia heard (“I thought I remembered seeing something a while ago about a theory that adults being around low level chicken pox infections often (what with kids everywhere) actually kept their immune systems in practice and made it less likely for them to get shingles.”) is correct, and is the basis of that slight remaining concern I have. Exposure to other with natural disease (friends, our own children, etc) traditionally acted as a sort of environmental booster, keeping our own antibody level against the germ high, which helped keep it dormant within us. Aging pediatricians uncommonly get shingles because of that. There is concern that the lack of that environmental booster effect will cause more shingles (also referred to as “zoster”) in those who had natural disease at a younger age.

Approximately 30% of people will develop zoster during their lifetime. Risk factors for zoster include age (beginning about 50 years), immunosuppression, female gender and varicella infection early in life, either in utero or before 12 months of age.

Among adults, repeated exposure to children with varicella is associated with a lower incidence of zoster. An observation was reported in 1965 that the incidence of zoster among pediatricians who routinely cared for children with chickenpox was lower than in the general population. The theory is that repetitive exposure to VZV boosts the immune response and protects against reactivation. With the dramatic reduction in varicella since licensure of the varicella vaccine, boosting of the immune response from exposure to children with varicella will be less common, raising the possibility that zoster may become more common.

In 2006, the Food and Drug Administration (FDA) licensed the zoster vaccine for prevention of zoster in people 60 years of age and older based on results of the Shingles Prevention Study. The results of this clinical trial demonstrated that the incidence of zoster was 51% lower in the vaccine group than in placebo recipients, and the incidence of post-herpetic neuralgia (PHN) was 67% lower among vaccinees

So Cazzle’s anecdotal observation may be spot on and is consistent with what I have seen: somewhat more shingles, albeit generally mild cases, in younger people who had had natural disease.

@Eva_Luna

… my sister was very surprised to be diagnosed with shingles last year, as to the best of Mom’s recollection, neither of us ever had chickenpox, and the vaccine didn’t exist yet when we were at the regular age to get it. I should look into getting it now, no? … my sister must have had chickenpox at some point then, right? Which means I may have, too, without realizing it?

@Motorgirl

I recently had myself tested for chicken pox immunity. I figured that at the age of 40 I needed to get immunized if I wasn’t immune … the blood test showed I did have chicken pox at some point. My mom swore I never had it, though, because I never had a fever, no pox, nothing.

Yup. A sizable portion of adults with no clinical history of chickenpox actually had undiagnosed mild cases and are already immune. The question is whether it is worth it to test them and only vaccinate those without antibody levels, or to just vaccinate them on the basis of the lack of clinical history. I lean to the just vaccinate camp - worst case you might lower their risk of shingles some. IMHO.

[Omar_Little]

Even if your kid hadn’t gotten the vaccine, he probably wouldn’t have contracted chicken pox until now, not because of some sort of negative reaction to the vaccine, but because the majority of kids today have received it and chicken pox isn’t transmitted as much as it was when we were kids. The vaccine works, that’s part of the reason that your kid didn’t get it until now. It just doesn’t work for a small % of the population and your kid is part of that. It’s not the vaccine’s fault, it’s your kid’s genetic make-up.

[amanset]

@CairoCarol

So why not get the vaccine? Adults can get it too.

To be honest, I didn’t know I could. It is something I’ll discuss with my doctor. Is it one of those ones where you have a small chance of getting the illness too?

[VunderBob]

I had chicken pox the hard way. My son also had chicken pox, he got it before we got around to vaccinating him. I kick myself for not getting the vaccination done simply for the disruption the pox caused, keeping him out of daycare for 2 weeks.

For some reason, when I was a kid, my mother was adamant that I not get the rubella vaccination. When I became an EMT, I had to get the vaccination or I would not be allowed to practice. I got the shot. :grumble:

There’s 2 reasons for getting it done…

[Hari_Seldon]

@Minnie_Luna

I had Chicken Pox at 16 and was one of the statistics. My case was so severe I ended up hospitalized. I wasn’t just covered with scabs, I had lesions in my eyes, down my throat, in my ears and another rather painful place. I ran a very high fever that would not come down with OTC medication. My mom had been in contact with my Dr. and when they finally decided to bring me in they had a nice little isolation room ready for me. I was in the hospital for 3 days, but I don’t remember too much of it. I do remember the side effects of the Bendryl and that was when we found out that Benedryl makes me wacky.

I missed almost a month of school.

I got it when I was 15 and my case wasn’t as bad as the above, it was pretty dreadful. Our family doctor said he had never seen anyone die from it, I was the closest, although I was not hospitalized. I itched unbearably for two weeks and missed about three weeks of school.