Total agreement with Guin. Yes, chicken pox parties carry a risk of becoming ill enough to require hospitalization (< 0.3%) or even death (0.0025%). The vaccine, however, carries the risk of anaphalactic reaction, which can lead to hospitalization and death. Everything carries a risk. Getting into the freaking shower in the morning is a risk, fercrissakes, 'cause there’s a finite chance you might slip, fall, and crack your head open. You could trip going down the basement stairs with a load of laundry, fracture your spine, and never walk again. You could be run down by a maniac crossing the street. Your plane could crash and trap you in an inferno of death. Life is a risk.
Of course, the issue with the shingles statistics is that shingles becomes more common as one ages. The vaccine has been in common use in North America only for, what, 10 years? I’m not sure I’d be convinced by any data that doesn’t compare similar age ranges, vaccinated and not.
Potential risks associated with administration of any vaccine are dwarfed by the risks associated with contracting infectious diseases.
By this logic, why have a Consumer Product Safety Commission? Why mandate quality controls for drugs (you probably won’t get that bad lot of antibiotic)? Why run crash tests on cars (the odds of your being in a really bad accident are small)? When your number’s up, it’s up - right? :rolleyes:
Maybe a few decades from now we’ll have all the herpes zoster (shingles) data needed to satisfy the most stringent doubters. However I don’t see the point in waiting around, while we can do a lot of good at minimal risk.
Jackmannii, I feel like we’re both arguing that the Pope is Catholic! I’m for the vaccine (with the concerns about what will happen when that population gets old), and see no point in exposing kids to the virus if they’re vaccinated against it, or going to be. Nowhere in this (or any other) thread have I counselled anyone to avoid vaccination for reasons other than standard medical contra-indications.
My youngest, who has chronic health problems, would have gotten the vaccine with my wholehearted approval had it been available at the time. As it was, both her physicians (and she has 4 separate specialists involved in her care) and I were glad as hell she got the chicken pox and got over it quickly, during a period where she was basically healthy. That had actually been the goal; catch it when she was able to handle it.
As for my eldest, we’d have gone along with her doc’s recommendation about the vaccine for her. But deep down I’d still worry that we were trading a mild illness now for a severe one 5 or 6 decades later.
And I share all your concerns regarding the vaccine avoiders. I’ve argued in more than one thread here in the past about the dangers of avoiding MMR and pertussis vaccines, and even flu vaccines for the targeted populations (altho a recent study on the flu vaccine indicated that giving it to someone just because they’re elderly may not be very beneficial; we have to wait for more data).
dropzone, you still don’t seem to get my point. I’m a lukewarm enthusiast of the vaccine, because I’m worrying that we might have an epidemic of 60+ year olds with horrible disfiguring and life-altering (or ending) cases of disseminated Herpes Zoster half a century from now. Nontheless, I recommended my patients get the vaccine when they met the criteria, and told people here that getting the vaccine isn’t wrong, and to discuss it with their physicians. I figure if you’re going to have your kid vaccinated, and your community at large vaccinates, there’s no sense in exposing your kid to the virus.
But if the vaccine is not used in your area (and many nations with strong public health programs are still not sold on the benefits of the vaccine for the population as a whole), and you still have a large pool of virus in your community, it still can make sense to expose a healthy kid to it and hope they get it over with relatively easily, rather than when they’re older and it’s 10 to 100 times worse. My kids both got their infections before the vaccine was used in this country.
Also, I still don’t understand how you’re reading that our neighborhood kid on Chemo got abused somehow. Standard precautions were taken regarding infection prophyllaxis, but she was not expected to live in a bubble. When an unknown and inadvertant exposure happened (she spent time with my daughter hours before my daughter’s unexpected outbreak), she swiftly got appropriate treatment per protocol.
Okay, looking back I probably (probabl?) overlooked where you said that the exposure was before your daughter’s outbreak and how your daughter had been unable to contract the disease until catching it from her teacher even though you had purposely innoculated her with an X-Acto* and some pus collected from her playmates and all the other mitigating circumstances you mentioned. I apologize to you and the unknown oncologist; I was imagining the hell I’d have to pay if that happened to my chemo daughter on my watch. She would have to stay in a bubble unless her mom took her out of it. Then if she got sick I’d still be able to maintain my personal and moral superiority. (What? Marriage isn’t supposed to be a game of upmanship?)
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- I know, that didn’t actually happen and if it did you’re an MD and get REAL scalpels which are much sharper than X-Actos, but I’m enjoying that scenario. You’re dressed like Jack Elam in “Cannonball Run,” too, down to the week’s growth of beard and the bottle of cheap whiskey. If I’m going to destroy our friendship I might as well take it all the way, right?
- I know, that didn’t actually happen and if it did you’re an MD and get REAL scalpels which are much sharper than X-Actos, but I’m enjoying that scenario. You’re dressed like Jack Elam in “Cannonball Run,” too, down to the week’s growth of beard and the bottle of cheap whiskey. If I’m going to destroy our friendship I might as well take it all the way, right?
Well, dropzone, as you seem to have recently realized that Qadgop wasn’t actually running around smearing cancer patients with my and my sister’s pus, I’ll have to delete a lot of this lovely post I’d written. But given some of what you originally said…
… I’m still going to have to stick with my original point, which was as follows:
Dropzone: FUCK OFF.
Every time we were knowingly exposed to chicken pox, the 'rents kept a close eye on us throughout the incubation period… and funnily enough, I don’t seem to remember our little neighbor visiting during those times. It completely surprised us all when I caught it from the teacher. But anyway, yes, it certainly was irresponsible of her oncologist to let her spend time with a doctor’s kids whose exposure to major infectious diseases was watched as carefully as it could be. :rolleyes:
Also, if you continue to make hi-LARIOUS comments like “Of course, you, as an MD, assumed you were right regardless what anybody else said,” I may have to tell you to fuck off again.
That’s not what I was saying, and you bloody well know it. I was referring to all the people who are shrieking and wailing about how it’s just so stupid and irresponsible to expose your kids to chicken pox, because there’s a tiny chance that something bad might happen to them. By that logic, nobody should ever do anything, because there’s a non-zero chance of a bad outcome.
And yes, the odds of you having a bad outcome from chicken pox is acceptably small. You have higher odds of getting pregnant after tubal ligation, fercryinoutloud.
Just for the record, why is it that the older you are, the worse chicken pox will be for you?
Oh, I guess your experience with medical types, doctors of all stripes, nurses, and anybody who has ever worked in a hospital or clinic, is different from mine. You are blessed, then. My own experience is that there is no tellin’ them nuthin’, no matter how far afield from their speciality they are speaking.
Qadgop, the position you’ve taken here is that you’re a lukewarm supporter of the chickenpox vaccine, and seem to be saying that to vaccinate one’s kids is OK, and not to do so is an individual decision that’s alright with you too.
It should not be overlooked that this position is far outside the medical mainstream, and counter to the recommendations of major pediatric and family practice physician groups, as well as organizations dedicated to promoting public health, such as the Centers for Disease Control.
You’re welcome to espouse an unorthodox view here (and I’m not suggesting you be burned at the stake for it), but it needs more support than just your gut feelings. I would be more in tune with your concerns if you could document them via respected sources in the public health field - for instance, the suggestion that immunity conferred by two doses of chickenpox vaccine won’t last as long or be as effective as immunity obtained from having the disease.
And while I doubt I’m ever going to get a reasonable answer to this from anyone here, I’ll pose it one more time, as it speaks directly to the ethics of holding “chickenpox parties”. The CDC (from the same site earlier quoted by both me and Qadgop notes that the prime source for contracting chickenpox in older persons and the immunocompromised, populations at higher risk for severe and fatal complications, is sick kids who have never been vaccinated.
“It’s a good thing if my kid gets chickenpox now while he’s young, seeing as it’ll be a mild case (it’s always someone else’s child who gets really sick). And if my child transmits the infection to a person who’s chronically ill or on immunosuppressive therapy, that’s their lookout. My kid comes first.”
The public-spirited parent of today. :dubious:
Oh, I’ve had the misfortune to hear of and interact with plenty of pompous idiots who think that their degrees make them experts on everything that has been or will be discovered about the human body.
… but I don’t assume they’re criminally arrogant until I have, you know, some evidence of it.
My take on it as well. While parents of my generation didn’t have “pox parties” which sounds sorta trendy-ish, they did purposely take their children and expose them to another known to have it.
My daughter is 25 and my son is 13, I don’t remember there being a vaccine back then. And there wasn’t one when I was a kid. But anyway, to 100th the notion “it’s only chicken pox” um yeah, it’s ONLY chicken pox.
Of course, if contrary to what some posters here have said, the vaccine DOES actually work, then yeah, I’d prefer that to itchy cranky kids.
Hey, wait a minute… Aren’t you a doc at an (adult) prison?
Where are you getting this from??? I tell my patients I think they should have the vaccine. If they refuse, I don’t force them to have it, or call child protective services. Do you? How can I not be OK with their refusal, anyway? Am I supposed to dismiss them as patients if they don’t follow my recommendations regarding vaccinations? I got on board with the Varicella vaccination program at its outset, as its otherwise a futile gesture to start at all, unless we are committed to vaccinating as much as the population as possible. But I’m just not sold 100% on it as a wonderful idea, as you seem to be. Stop painting me as someone adhering to some anti-vaccine agenda quackery!.
Anyway, there’s still plenty of debate and discussion going on among immunologists about what is going to happen long-term with this vaccine. I think the World Health Organization does a nice summary about the disease and the vaccine, along with hopes and concerns here: Varicella Vaccine. It includes the pros and the cons along with a good review of the subject.
The above is what I fear. That’s why I was not eager to start the mass vaccinations. But once begun, there’s nothing for it but to get the population covered as best as we can, and see how it goes.
And from the CDC:
Success may depend on not only getting our nation 90+% vaccinated, but getting most of the regularly travelling world up to that level also.
Metacom, I’ve been working in a prison for 3 years. For 17 years, I did Family Practice, which for 6 years included delivering babies. It also included pediatrics & gynecology. I’m getting a bit rusty in those areas, but I haven’t forgotten them.
[hijack] Not to nitpick (well, OK, maybe just a little), but even the article you’ve linked to discusses the collapse of the medical system in the FSU during perekstroika and after the dissolution of the Soviet Union as the primary cause of the drop in vaccination rates there, not any kind of widespread influence of an anti-vaccination movement. This jibes with the reading I did in the mid-90s on the subject in preparation for enrolling in an academic program in lovely Novosibirsk, Russia (including updating my diptheria and tetanus vaccinations, though I blew off the Hep A). T
he medical system there at the time was pretty disastrous; it was difficult to lay hands on things as basic as penicillin that wasn’t years out of date, let alone anythign that wasn’t perceived as an immediate need. You should have seen what happened when one of my classmates came down with dysentery; a doctor had to be brought in from 100 miles away.
Which reminds me, the DT booster is good for 10 years, right? It’s time to do them again, then.
I have not done so. I have pointed out that you are well out of the medical mainstream based on statements such as these (from one of your earlier posts:
You have not supplied justification for these statements. The WHO, the latest authority cited, is pro-vaccine for both economic and health reasons in developed nations and does not suggest that deliberately exposing one’s children to the disease is a reasonable alternative. From the WHO link: “If sustained high (vaccination) coverage can be achieved, the disease may virtually disappear”.
So when you say that pox parties are not necessarily a bad idea, or suggest that vaccination may be less beneficial, it strikes me that you are encouraging the very scenario that you say you fear (poor control via non-compliance with vaccination recommendations). Not to mention (again) downplaying the effects of a practice that could injure or kill susceptible persons in the here and now, when exposed to numbers of sick children.
I’m not trying to pick on you, Qadgop. I recognize that you are in a position to influence opinion on this board, based largely on a lot of good advice you’ve given out in the past. I think you are off base in this situation.
Eva, the main reason I linked to the article on diptheria in the former Soviet Union was twofold - one to show what happens when vaccination programs break down, and to indicate that anti-vaccination attitudes can play a part in these situations, not necessarily a dominating one.
In the case of “pox parties” - I don’t know that anti-vax fears are a major influence, but the background whispering and paranoia that I see covered in the media and in other forums can’t help but push some parents towards making bad decisions (for their kids and for society).
In reading that, I’m reminded of a line from Orwell’s Nineteen Eigty Four, “I’m authorized to say that the war may actually be within measurable distance of the end.” A totally meaningless phrase. Either CP will disappear with widespread use of the vaccine or it won’t. The WHO statement you quote is a bunch of weasel words used to hide the fact that nobody really knows what will happen.
That’s why I still worry about the program. I hope WHO is right. But if having my doubts puts me out of the mainstream, so be it. Meanwhile I’ll be an obedient physician/citizen and continue to encourage vaccination for Varicella.
How can that possibly be the case? When you consider the extraordinary measures that had to be taken to wipe out Smallpox, hope that the CP vaccine use is that widepread seems overly naive. Unless the vaccine is in use everywhere by everybody, than the potential for it to spread is still there.
This is a WAG, but when you consider that Smallpox was the only disease that this has been done for, may it is saying that the 0.00025% chance of death in kids and 0.0309% chance in adults isn’t worth the effort. At least not when compared to the 30% mortality rate that smallpox had.
First of all, smallpox is not the only disease that we could ever expect to be eradicated by vaccine. We are close to eliminating polio (it is already virtually unknown in developed countries) if resistance to the vaccine based on non-scientific grounds can be overcome.
Herpesviruses (like the one that causes varicella/chickenpox), based on their ability to lie dormant in the body for long periods following initial infection, are more difficult to eradicate than those that produce only acute illness. If you won’t accept less than 100% effectiveness in eradication then you will regard this and most other vaccination programs as failures. But greatly reducing the incidence of an infection via vaccination spares a lot of people from an unnecessary illness causing real health and economic consequences, at very low risk.
In the face of uniform support for the varicella vaccination program from major pediatric and family practice physician groups, public health organizations and infectious disease experts. I’d say it’s worth following.
It’ll be interesting to see how public response will be to two major vaccine initiatives that’ll be coming down the line in future years - immunization against HIV and HPV (the papillomavirus that causes cervical cancer).