| To Immunize or Not to Immunize: That is the Question |
By: Tina Boscha, Columnist, “Kids & Health”
On 2/18/06
When I was a kid, children weren’t immunized for chicken pox. It was expected that we would contract it, go through some itchy, feverish misery for a few days, recover, and go on with life, never fearing chicken pox again.
| "In the end, it always comes down to your judgment and situation. If outbreaks are common in your area, perhaps a vaccine is a good idea. " |
It was a mark of maturity to understand that having chicken pox meant you wouldn’t get it again. My own particular case came after my brother had it. I was lucky in that my bout with the illness wasn’t so bad; strep throat was my particular enemy. I remember the spots and some itching, but in general, I felt okay.
Now, along with the measles, mumps, and rubella vaccines offered, a vaccine for chicken pox is also available and recommended for children 12 to 18 months of age. Introduced in the US in 1995, the vaccine is not without controversy. Is it necessary? In the long run, will it do more harm than good?
Before tackling these questions, it’s important to understand the basics of chicken pox. While I believed (until I did some research) that once you had chicken pox, you were protected for life, this is not actually true. It is possible to contract chicken pox for a second time, and more commonly, to get shingles. My father had shingles for a period of a month, and the experience was quite painful. It turns out that individuals over 60 who once had the chicken pox are most likely to get shingles, and there isn’t much available to treat it.
Therefore, it seems that chicken pox isn’t as mild as once thought. Still, it's a subjective issue. In most cases, chicken pox is a mild illness - for children. It may be uncomfortable, but in general, the illness lasts about a week or less and individuals recover with little lasting effects (aside from a few scars from overzealous scratching, perhaps).
Chicken pox can, however, affect people with compromised immune systems and become more serious. Adults with chicken pox often have a severe bout. According to www.webmd.com each year 100 people die from complications from the disease, and thousands are hospitalized. Add to this the possibility of getting shingles, and the idea of a vaccination sounds pretty good.
In general, the vaccine has proven to be largely successful. In one particular case, an outbreak of chicken pox at a Maine elementary school demonstrated that children who had been vaccinated either did not contract the disease or contracted a mild form. Unvaccinated kids were not only more likely to get chicken pox, but were sick for longer and had more severe symptoms.
On the larger scale, the vaccine is quite effective in warding off the disease or weakening the illness if it is still contracted. Furthermore, reactions to the vaccine tend to be nothing more than a mild rash and some irritability, typical side effects for most vaccines, and far easier to handle than the illness itself.
However, some experts worry that a vaccine against chicken pox may actually increase the likelihood of contracting the disease a second time, or as an adult, when the illness tends to be more severe. The reasoning is that since individuals used to be exposed repeatedly, their immunity was continually boosted. With more people immunized, outbreaks will be lessened in the short term, but a stronger form of chicken pox may emerge and cause a more severe outbreak – even in those who have been vaccinated.
Currently, no booster is required for the chicken pox vaccine. Simply put, the immunity may not last as long for those who got the shot, and for those who didn’t, their natural immunity won’t be enough.
Right now, most medical experts feel immunizing young children is a good idea, and perhaps “catch-up” vaccines for older children can be beneficial too. Some adults are choosing to get the vaccine in order to ward off getting shingles. Like the flu shot, a vaccine might be good for children with compromised immune systems, including those with eczema, asthma, and other auto-immune and allergic conditions.
So what should you do? As with most things, asking your pediatrician for some advice is a good idea. In the end, it always comes down to your judgment and situation. If outbreaks are common in your area, perhaps a vaccine is a good idea.
This is what Dr. Greene of the popular web site www.drgreene.com chose to do for his youngest child, although his older children are not vaccinated. And while it may be difficult to make the decision based on money, an unvaccinated child will most likely get chicken pox, and missing a week of school, plus work and day-care, for a preventable disease may outweigh other factors.
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