Chicken pox vaccine: better than a party? A Pox on Your House, by Sasha Brown-Worsham for Babble.com.Sasha Brown-Worsham
When Leslie Richman’s two-year-old twins contracted the chickenpox, she considered her options – be quarantined in her house for up to a month or, host a party, allowing other unvaccinated children to lollipop lick, germ breathe and touch their way to shot-free chicken pox immunity.
She opted to party.
After more than a decade of vaccination, chicken pox parties are gaining steam again, especially in cities like Boston and New York where middle-class parents, wary of potentially unnecessary vaccinations, are opting for their children to earn their immunity to chickenpox the old-fashioned way – tucked into bed, covered in Calamine lotion.
“I tried to see it as an opportunity to offer people a choice for their child other than getting poked with a needle,” says Richman, the Boston-based CEO of Forget Me Not Tots who had her sons on a staggered vaccination schedule that left them vulnerable to the highly contagious wild chickenpox virus – an ailment that is now so unusual, that the Richmans’ own pediatrician had to call in several others to confirm the diagnosis.
A person who has chickenpox can transmit the virus for up to 48 hours before the blister-like pox appear, and they remain contagious until all spots crust over. Vaccinated people are usually immune to the virus, but so are those who have had the virus. After the child has contracted chickenpox, his or her body creates antibodies that are stored for a lifetime. Critics of the vaccine argue that this natural immunity is more time-tested than the just-over-a-decade old vaccine.
“We did not mean to end up with the chickenpox,” says Richman whose children could have been exposed at the grocery store, coffee shop or even on the subway. It enters through the upper airway like common cold and flu viruses. “But I am glad we did.”
At first, the viral infection causes minor respiratory symptoms; it then enters the bloodstream in increasing numbers, traveling all over the body. A week to three weeks later, the body begins to make antibodies against it and that is when the fever begins, along with fatigue, stomachache, headache, and other flu-like symptoms. Many of those with the active illness think they have nothing more than a cold while they are the most contagious.
Though it was unplanned, the virus felt like a “rare gift,” says Richman who sent an email invitation to her Boston mothers’ listserv and was overwhelmed by the response. “The next day, I had 350 emails, most of them asking if I was insane.
The haters have a point, say most doctors. The American Academy of Pediatrics recommends two doses of the vaccine and ninety-four percent of pediatricians offer it. “Getting the disease has a worse consequence than getting the vaccine. Ten percent of unvaccinated kids will have to see a doctor because of the disease,” says Robert “Doug” Hardy, MD, an infectious disease specialist at Children’s Medical Center Dallas and University of Texas Southwestern Medical Center. Richman experienced this herself with her two sons. “My first son was just not that sick,” she explains. But her second son ended up with an infection that landed him in the Emergency Room.
“Complications for unvaccinated kids are dehydration, vomiting and pneumonia,” says Dr. Hardy. “One dose of the vaccine is ninety percent effective against severe cases of the disease.”
Prior to 1995, when the varicella vaccine – the vaccine that prevents chickenpox – became widely available, parties like the one at the Richmans would have been commonplace with the infected child as the belle of the ball playing with the children whose parents were hoping for the virus to strike while it was still a relatively innocuous – if annoying and itchy – ailment.
Twenty-five years ago, I went to a few of my own. My mother had me all but make out with my neighbors in order to contract the disease, but to no avail. It was not until I was eleven – and then completely by accident – that I actually came down with the pox. “There are no guarantees, even with something as contagious as the chickenpox,” says Richman.
Many parents in their late twenties and early thirties remember their bout with the pox almost fondly, despite the itching and occasional scarring. I remember my weeklong vacation from school that November, spent taking Aveeno baths and watching Ferris Bueller’s Day Off on VHS. A couple weeks later, the only lasting consequences of my illness were a few scabs in my sixth grade yearbook photo and a lifelong immunity.
But when it came time to get my own daughter vaccinated at her twelve-month appointment, I took our pediatrician’s advice and got the shot for her, assuming she would appreciate the break we gave her from itching and scarring – two of the most common issues with the chickenpox. Of course, she won’t get to miss a week of school, either. “The vaccine cuts down on absenteeism,” Dr. Hardy points out – something that might disappoint vaccine recipients.
But for many parents, light scarring and a few days off from school seem a small price. “When it came time to give our son the chicken pox vaccine we once again had many discussions about the risks and benefits. We reminded each other that most of the time chicken pox is not fatal and it was actually a fun part of our childhood,” says Erin Tierney, mom to Liam, four.
“We knew that the life-long immunity is much more beneficial than the one given by the vaccine,” says Tierney. “We decided that we will wait until he is four and a half or five and then send him to a chicken pox party. This way he will develop the immunity, not have to suffer through another shot, and maybe even get to watch movies or redo his room while scratching.”
“Chickenpox is usually a mild disease with no serious consequences. Vaccine detractors, like Tierney, often point to the vaccine schedule, which has grown considerably since 1983. At that time, the mandatory vaccination schedule consisted of ten shots. Today, the Centers for Disease Control and Prevention (CDC) recommends thirty-six shots from birth to age six. In the Recommended Childhood Immunization Schedule put out by the CDC, twelve vaccines are given to children before they reach the age of two, including hepatitis B, diphtheria, tetanus, pertussis, polio, pneumococcal infections, Hemophilus influenzae type b infections, measles, mumps, rubella, chickenpox and influenza.
For many parents, cutting down on the number of vaccines just makes sense, especially for non-serious illnesses, like the chickenpox.
“Chickenpox, when contracted by a healthy child at a young age, is usually a mild disease that is self-limiting with no serious consequences,” says Sarah Bedell Cook, a naturopath and mother of one based in Colorado.
“It is a well-known fact that immunity from vaccination is limited and after a number of years wears off,” says Cook. “The manufacturer of the chickenpox vaccine admits that they have still not determined when a booster shot will be needed. By immunizing all of our children with the chickenpox vaccine, what will happen when their immunity wears off? They may be fifteen, twenty-five, or thirty-five years old.”
In fact, many doctors do advise their patients to get a second dose of the vaccine at the age of four or five, just to be safe.
But Cook would rather her son’s immunity be earned the same way she earned her own. “We can inject our children with a vaccine whose duration has yet to be tested or we can take our kids to the next chickenpox party, miss a week of work to nurse their wounds, and know that we have given them lifelong immunity,” she says. “I know where I will be when the next party invitation is sent.”
She is not alone. As of last year, more than a quarter of American children are not meeting the U.S. government’s recommendations for childhood vaccinations, according to the CDC. This is in spite of the fact that children without religious or medical reasons must have been vaccinated (or, in the case of chickenpox, had the disease) in order to enroll in public school.
But not all people agree, and many of the angry emails Richman received came from adults who had yet to contract the virus. They accused Richman of perpetuating an illness that could otherwise be eradicated.
For adults who contract the virus, especially pregnant women, chickenpox can be dangerous, even deadly in some cases, and rife with complications, including common pneumonia and encephalitis. A 2001 British Medical Journal study found that eighty-one percent of the deaths attributable to chickenpox over a recent twelve-year period in Britain were adults, not children. But for kids, it is mostly an itchy inconvenience – a minor blip in the memory of anyone over thirty.
In fact the Encyclopedia of Medicine of the American Medical Association stated in 1989 – just 20 years ago – that “all healthy children should be exposed to chickenpox . . . “
Now parents have a choice – and it is often a vexing one.
To most doctors, the answer is clear, says Anatoly Belilovsky, a New York City-based pediatrician who says that complications from the vaccine are less common than complications that arise as a result of the virus itself.
For a vaccine that is eighty percent effective after one dose, the odds are pretty good. “Fever was reported in about twenty percent of recipients (that’s all fevers, not necessarily vaccine related). About four percent had ‘mini-chickenpox,’ with five or fewer non-scarring lesions.”
For a vaccine that is eighty percent effective after one dose, the odds are pretty good and even the twenty percent who do get the disease in spite of the vaccination often have a very mild case, Dr. Belilovsky says.
“In my own experience, the ‘breakthrough’ chickenpox, months to years after vaccine, is milder in fever duration, in severity of malaise, and in size and depth of lesions – they are too small to scar, and heal much quicker than lesions in never-vaccinated children,” says Dr. Belilovsky.
Many parents are not convinced and as long as they are not, there will always be wild strains of the virus to be found, whether at a party or Whole Foods.
Despite the animosity from her listserv, Richman and her sons did host a few play dates. To her knowledge, none of their visitors contracted the disease, despite varied and creative attempts to do so: “I had strangers encouraging their kids to practically lick my kids,” says Richman.
“It is not what we planned,” she says. “But now we are done with it and I am glad it happened the way it did. I don’t have to worry about that anymore.”