regarding the chicken pox vaccine

Our son’s doctor wants to give him a chicken pox vaccine at his 12-month check-up (he’s nine months old now). I’ve heard some grumblings about it to the effect that it’s supposed to immuze him, but may not guarantee that he won’t catch it. That, if he does catch chicken pox, the vaccination may make it a more mild case with fewer lesions and less discomfort.

When I was young, the going theory was that if one of the neighborhood kids got chicken pox, send your kid over, they catch it, and then they’re immune for the rest of their lifetime. Which, by and large, is a true statement. I realize that there can be serious side effects from kids having chicken pox.
His doctor seems to think that this vaccine is a good idea; that it’s been in use in the U.S. for several years and there’s been great success. But, since it took us SO long to conceive the GrizzCub, we tend to question everything.

Which brings me to my questions…
Should we allow the vaccine to be given?
If we do, should we expose him to chicken pox anyway?
For males, is it dangerous to the reproductive organs to have chicken pox as an adult? I know that mumps as an adult male is BAD, but is it the same for chicken pox?

And, for those who became parents in the last dozen years or more, did you child have the chicken pox vaccine? If so, what was your experience with it?
I never imagined how much I’d enjoy being an overprotective father!

Our pediatrician recommended that our children get the vaccine only if they do not get chicken pox by the time they reach school age. His reasoning is usually the younger they are when they get chicken pox the milder it is. As they get to their teenage years it is worse and it is downright dangerous for an adult to get chicken pox. One of his concerns with the vaccine is that it apparently has not been around long enough to know whether one shot will last or if it will eventually wear off and need a booster.

GrizzCub’s doctor says that, in theory, the vaccination should last a lifetime. And that no booster currently exists.

But just HOW is it dangerous the older you get? Respiratory? Reproductive?

I dunno about the effects on the reproductive system but I can speak first hand as an adult who had chicken pox. The summary is that it isn’t that much fun. I caught it in January from my niece and nephew, they bounced back in about 48 hours…I ended up sleeping twenty hours a day for five days, and it took about three months till my energy level recovered to the same level as it was before I had the chicken pox. From what I’ve read that isn’t unusual, and based on that I would recommend that everybody young or old who hasn’t had the chicken pox should have the vaccine…you really, really don’t want to go through what I went through.

Keith

It’s clear that not everybody has a great response to the chicken pox (AKA varicella) vaccine. The thinking is that individuals with a suboptimal response may develop mild chicken pox upon later exposure.

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Actual infection is more effective than vaccination in promoting immunity to chicken pox. There is concern that vaccine-mediated immunity may not be lifelong as is the case with infection-mediated immunity. Nonetheless, studies from Japan (which has a longer history of chicken pox vaccine use) suggest that even at 20 years, protective immunity is maintained.

The down side of getting immunity from the actual infection is that many individuals develop complications.

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::Applause::

A pro-active approach is commendable.

Depends on your personal assessment of risk/benefit.

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Chicken pox is still quite prevalent (though that may change if the vaccination campaign is successful). Chances are that your cub will be exposed during childhood without intervention. Whether or not you should expose him intentionally is another one of those personal risk/benefit situations. With post-vaccination exposure, your child may get a sub-clinical (i.e. no symptoms) chicken pox infection that will foster lifetime immunity. He may get mild chicken pox infection that will also foster lifetime immunity. Less likely, but still possible (IMHO) is that he gets a clinically significant chicken pox infection with the attendant risks of complications. Even in this case, however, lifetime immunity is conferred.

There’s no study that explores this question directly so it’s difficult to make a concrete recommendation. I’d guess that whether you intentionally expose the cub or no, once vaccinated, he’d be well-protected from serious chicken-pox infection for life

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There is no male/female preponderance of severe complication to adult acquired chicken pox infection. Complications are bacterial infection of skin and subcutaneous tissue, a severe varicella pneumonia, myocarditis, hepatitis, and CNS infections. Except for skin infections, these complications are all more common in adults or immunosuppressed individuals.

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Both of my kids (ages 2.5 and 5) got it. They both tolerated it well.

Amen to that. They’re just sooooooo cute :slight_smile:

No recommendation for a booster currently exists. Boosters consist of the same stuff as the original vaccination, just given a second, third, or fourth time

I just thought I’d mention that the herpes virus which causes Chicken Pox remains in your body the rest of your life and can become active again. This happens not infrequently and is called shingles or plain herpes. It has happened to me and it sucks. I imagine that full blown chicken pox in an adult must really suck big time.
http://www.aad.org/pamphlets/herpesZoster.html

Don’t intentionally expose your cub to chickenpox. He will be in danger of getting shingles as an adult if he contracts the live virus. Much better for him to get the vaccination, which I just got 2 weeks ago successfully.

Adults who get chickenpox run the risk of contracting pneumonia. Any adult who hasn’t had chickenpox should absolutely get tested and vaccinated.

this is OT, but the commercials for the Chicken pox vaccine I see on TV are so disingenuous and manipulative, it makes me want to puke.

Somebody asked me my opinion of this vaccine the other day and I emailed back a response. It’s probably badly written, but you’ll get the gist of it, anyway…

Very interesting issue(s), and gives you some insight about the politics involved even in this area - immunizations. Chicken pox (varicella) is usually a mild illness, and acquiring the illness gives lifetime immunity to the disease. Well, that’s not exactly true, as you then have latent virus that can re-emerge in the form of shingles/herpes zoster later on - usually in elderly, really stressed-out, or immune-compromised persons. Chicken pox is actually a type of herpes virus. Just about all of us got it as kids, and it is a milder illness in children than in adults. A friend of mine got varicella during pregnancy and had a miscarriage. She could have had a baby with birth defects because of it too, I’m guessing. Adults, as a general rule, get sicker and are more likely to have complications when they acquire the disease in adulthood.

So why immunize? Until now, almost all of us got it as kids and were done with it, and the disease was self-limiting - no big deal.

(I thought about immunizing Olivia because I didn’t want her to end up with scars on her face like I did and because we had some vacations planned and I didn’t want to get kicked off the plane. Sure enough, right before I made up my mind and right before our vacation, Olivia got it and ended up with a pock mark scar right between her eyes like an Indian bindy.)

Okay, so here’s the issue(s) about immunization. The shot is safe, but we don’t know if it confers lifetime immunity. Which means if you get the shot instead of the disease, you may need a booster so you don’t get varicella as an adult when it’s a worse disease (and can cause problems in pregnancy, etc.). But the pharmaceutical company (that served to profit from this vaccine) really pushed for universal immunization. Since some/many people are getting immunized against varicella, unimmunized kids are less likely to come in contact with the disease and get it early, so they are more at risk for acquiring it later in life when it’s more dangerous, too. So now we’ve artificially created this situation where we HAVE to push immunization because the disease is less common in kids and people won’t get it over with early. It has even become a state requirement for school entrance in many states now. I’m not saying it’s a bad shot… just that it wasn’t a really dangerous disease for most people IMHO. And many other vaccine-preventable diseases (measles, pertussis, etc.) ARE dangerous.

That’s a complicated answer - or maybe even no answer? I would immunize in infancy just so you won’t face the school entrance requirements later, or else plan to somehow purposely expose the kid to disease at some point if that’s possible so s/he will have better immunity later and won’t possibly need a booster.

You can find more info. at http://www.cdc.gov, where you will find a link to the national immunization program.

contrary to popular opnion varicella (chicken pox) can be a fatal disease. one adult and one child die each week in the u.s. from chicken pox. we lost a 9 month old from our practice 18 months ago. she caught it from her 3 year old brother. mom had decided to “wait a while” for his shot. he got a mild case, but sissy died.
the vaccine is not 100% effective, but if you do get the disease after vaccination, there are typicaly 5-10 lesions, as opposed to 100-200 from a so called natural disease. of course , if one could be sure their child would have a mild case, i’d say just let them get it. but how can you be sure? are yu willing to risk your childs life?
you may need a booster after ten years or so, the results are not clear on this yet.
as for reactions to the shot, usually there are none or minimal. the major reaction is a varicella like rash 1 month or so after the vaccine. suseptable persons can get varicella from touching open lesions. however if they are kept covered (say, bandaids), there is no danger. these lesions are not airborn contagous as is varicella. sometimes a slight fever.
as far as i know, human beings are the only vector for varicella. we could eliminate this disease, like smallpox. and i understand the world health orginazation expects polio to be eradicated within the next few years.
i have heard all kinds of reasons for not getting immunizations, ranging from religous reasons to “it would hurt”. however, i am old enough to have seen children with diptheria, tetnus, polio, hib and a lot of preventable diseases. in my opinion, any one who neglects their childrens immunizations are being extremly foolish and dangerously close to child abuse.

[[however, i am old enough to have seen children with diptheria, tetnus, polio, hib and a lot of preventable diseases. in my opinion, any one who neglects their childrens immunizations are being extremly foolish and dangerously close to child abuse.]]

I completely agree with you. But I would not put varicella in the same category as those other diseases. It’s true that it can be fatal, but this is very, very rare. There are other diseases that can also be fatal that we could vaccinate everyone against but we don’t, because they are so uncommon.

My doctor’s practice refuses to recommend varicella as a required shot–it’s up the parents. They consider it experimental, unnecessary, and limited in its long-term proven efficacy. They had a similar stance on Rotovirus, and then that sucker got pulled.

It’s my intention to wait until Cranky Jr is five. If he hasn’t caught it by then, he’ll get the shot–mostly because it’s the stupid state law, but also because thanks to vaccine practices (as Jill noted) we now have a situation where his chances of catching it young are diminished. At least at age five, his own immune system will be more mature, and they’ll have that much more experience/research on the vaccine. I’ll be more comfortable giving it to him under those circumstances.

I think my doctor’s attitude is somewhat rare though, as most of Cranky Jr’s peers I know had the vaccine as a matter of course with their 12-month shots.

I too had Chicken pox as an adult and have first-hand experience with how awful that can be.

As for the risks? Give me a break. I am sure I can find plenty of anecdotes about the rare kid who died of it. Hell, the vaccine companies take out ads in parenting magazines to tell me about it. One kid dying a week is 52 a year, out of how many kids who live in this country? Yes, I guess I’m “risking his life” but it’s a risk I’m willing to take (so is my doctor). If I were that risk averse, I would never have had a kid in the first place… much less ever get behind the wheel with him in the car.

I believe the case/fatality rate for varicella is 1-3/100,000. It is more dangerous for people with leukemia and/or immunosuppression, but I’m not sure if the jury is in about whether those people should be immunized. I don’t believe getting the vaccine prevents one from getting zoster as an adult. The vaccine has been used in Japan for about ten years and so far most people are still 70-90% protected against the disease that far out. Don’t get me wrong here… I fully support vaccination against dangerous disease for kids. And I also think this vaccine is probably very safe. I just wonder if it will confer immunity for life, or if immunity will wane and we’ll have more adults getting the disease and suffering more for it.

There is also a debate going on about mandating Hepatitis A vaccine for school-age children. Hep A is typically a much milder disease in children than in adults and rarely leads to any kind of long term problems or death. There may be a profit motive behind the lobbying efforts to get that one forced on everyone, too. (FTR, I vaccinated my kids against Hep A because we spend time in countries where sanitation is more questionable.)

Do you have a cite to confirm that the vaccination confers protection against shingles? The last time I discussed this issue with a doctor friend (which was a while ago, when the vaccination was first widely available) he said that, while protection against shingles was hoped for, it had not actually been proven and perhaps had been disproven? The links above didn’t seem to have any info on this. Of course, it will take a long time to really know, as most cases of shingles occur in older people, so we need a large group of elderly people who were vaccinated as children.

Personally, I would use the vaccination only for people who don’t manage to get exposed as children. As it is, I’ll have to vaccinate my youngest if I can’t manage to expose her before she starts kindergarten. I’d rather wait until she is 8 or 10 before going the vaccination route. And since more and more people are vaccinating, it’s harder and harder to find someone with the disease. (If anyone has a contaigous child in the suburbs west of Boston, I’ve got a 3yo who would love a play date.)

I’m 25 and have never, to my knowledge, had chicken pox. I was around it LOTS as a kid; don’t worry, I was exposed on many occasions. My brother got it, I didn’t. A kid once broke out in spots sitting next to me in class. My mom was SURE I’d get it from that. Nope.

Is there a way to check to see if I somehow either had a weird subclinical case or am just somehow naturally immune? I’ve been thinking of looking into getting the shot but if I’m already immune, there’d be no point to it.

The CDC link that JillGat provided above tells us:

A blood test is available to test immunity in persons who are uncertain of their history or who have not had chickenpox. Many of these persons will find that they are immune when tested and thus will not need to be vaccinated.

I would strongly suggest that you ask your doctor for that blood test. You probably did indeed have an extrememly mild case. But on the off chance that you didn’t, you really don’t want to get it now.

I’m taking my kids in for the chickenpox vaccine. I discussed it with the health nurse, and decided that the health risks were minimal, and the benefit potential was acceptable. I can’t advise anyone else. I tend to think that vaccines are a good thing, however, since I’ve had chickenpox myself with no lasting effects other than a few scars, I was a little more ambivalent on this one. I suggest that you research the vaccine and the disease, and then have a good long talk with your health nurse.

whiterabbit,

I don’t know about being “tested” but I can offer myself up as a case of someone who was exposed numerous times as a child, including my own sibling getting it. I never did. Never, that is, until college. I had thought I was somewhow immune or had caught it without showing symptoms. But I learned (quite painfully!) that this was not the case. I was 18 and oh lord was I miserable.

Oh and BTW, to contribute to the numbers discussion, I read today that there are (or were, before the vaccine?) 4 million cases of chicken pox each year.

No, I don’t believe the vaccine can protect you from shingles if you have already had chickenpox. But if you’ve never had chickenpox, it will prevent you from getting the virus that causes shingles later on.