Chicken Pox Vaccine
Chicken Pox (also known as varicella, or varicella-zoster)
is a viral illness characterized by specific symptoms, including
fever, headache and congestion, followed by a rash. The rash usually starts
as red spots that then fill with fluid (vesicles) and go on to crust and
disappear, sometimes with a small scar. The rash can appear anywhere on the
body. The average child gets 300 spots.
Varicella Vaccine Remains Controversial
Routine vaccination of children against varicella remains controversial. A
survey of 172 physicians in Rochester, NY, was aimed at evaluating which physicians
vaccinate their patients against varicella, which don't, and why.
About three-quarters of physicians surveyed were pediatricians; the remainder
were mostly family practitioners or specialists in internal medicine (1%).
The survey results showed that pediatricians were more likely than FP's or
IM's to offer the vaccine. That was especially true of pediatricians whose
patients were covered by private insurance plans.
Overall, 63% of doctors administered the vaccine to some or all varicella-susceptible
children 5 years and younger; 57% administered it to children 6-11 years old;
and 74% gave it to adolescents 12 years and older. The reasons most often provided
for not vaccinating were:
- Varicella is a "normal part of childhood"
- Concerns that the vaccine may cause varicella to become a more
serious "adult" illness
- Children get enough immunizations already
- Only immunocompromised children should be vaccinated
- Mass vaccination is too expensive
Schaffer SJ, Bruno S Varicella
immunization practices and the factors that influence them Arch
Pediatr Adolesc Med 1999 (Apr); 153 (4): 357-362
Chickenpox Vaccine May Increase Shingles Risk in Elderly
Vaccinating children against chickenpox (varicella) could increase the risk
that adults would develop shingles, a painful blistering rash that is potentially
dangerous in the elderly.
A team, at Britain's Public Health Laboratory Service (PHLS), said that although
vaccination would save thousands of lives over time, thousands of elderly people
could also die from the complications of shingles, known as herpes zoster.
Writing in the journal Vaccine, they called for a re-evaluation of the policy
of mass chickenpox vaccination that has been introduced already in the United
States and is imminent in many other countries. In 1995, the chickenpox vaccine
was approved for use in children over 1 year of age in the US and is now required
for school entry.
After a bout of naturally-occuring chickenpox, the varicella zoster virus remains
dormant in the body and may reactivate decades later to cause shingles, a painful
rash that typically strikes chickenpox veterans after the age of 60.
Marc Brisson and his team say their research shows that adults living with
children have more exposure to the virus that causes chickenpox and enjoy high
levels of protection against shingles. Being close to children means that adults
are exposed to the virus, which acts like a booster vaccine against shingles,
they believe. But if all children were vaccinated, adults who have had chickenpox
would no longer be protected against developing shingles.
The researchers worked out a mathematical model that predicts that eliminating
chickenpox in a country the size of the United States would prevent 186 million
cases of the disease and 5,000 deaths over 50 years.
However they said it could also result in 21 million more cases of shingles
and 5,000 deaths.
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