What about Chickenpox?

Even Pediatricians were uncertain.  We knew that chickenpox was common and occasionally serious, but almost always in older people, hardly ever in young patients.  So we dutifully began to vaccinate kids above the age of 8, as we explained to parents it was important to protect the older kids "for now".  (This would become a problem for us going forward, which I will soon demonstrate.)

It was about a year after the vaccine had been "rolled out", that the infection specialists belatedly began to orient us, the doctors, to its POWERFUL selling points:

During the twentieth century, there were an average 100 deaths of children annually from chickenpox, most of them previously healthy individuals.

Approximately 1 in 5000 children would have severe complications during the illness.  (This translates to 200 kids out of every million who would have frightening, often life threatening disease.)  The complications included:

Necrotizing fasciitis (known as "flesh-eating strep") as bacterial superinfection of blisters rapidly invaded the child's skin and muscles. This could lead to disfiguring surgery and amputation.

Encephalitis with brain inflammation and brain damage.

Reye syndrome with usually fatal liver and brain injury when kids with Chickenpox were treated with common Aspirin.

Hemorrhage (uncontrollable bleeding).

All of these were more common and more severe in immunocompromised kids who already had disease like leukemia or ongoing treatment with prednisone (used to help children with severe asthma, arthritis and bowel inflammation). 

Newborn infection was frequently deadly.  If a woman got chickenpox just before or after having a baby, the child could become severely ill and die.

Congenital malformation or death would happen to around 2% of infants of women who got chickenpox in the first trimester of pregnancy.  They could have permanent brain damage, blindness, and deformed arms and/or legs.

A sad case of which I am aware:  About 15 years ago, a family carried their 7 year old severely ill child with Chickenpox into the LIJ Emergency Room.  They had refused the Vaccine as they wanted their child to get the disease the natural way.

The boy was paralyzed from the waist down, in the way Polio used to damage the spinal cord nerves.  This is a known, tho uncommon chickenpox complication.

So we began to vaccinate all kids over one year old.  But parents were confused and anxious.  Why the change in our policy? Hadn't we stated that ONLY the older kids needed the shot?  That young kids were not in danger if they got chickenpox?   We had inadvertently undermined the best strategy to protect all of America's children.  We proceeded to do our best to correct the first, incorrect impression.  Many parents still refused the vaccine, stating concerns that the Vaccine might need a booster dose in the future.  That is a misguided reason to refuse a vaccine:  Most of the vaccines we use require booster doses, and they are well worth it.

In fact, ten years after the vaccine release, the infection experts recommended a second, booster dose to be given at some point to all children.

This was advised because Varivax (as the vaccine is named) is not 100% protective.  While it gives 95% protection against getting SEVERE chickenpox, about 20% of recipients still did get a mild case some time in the future.

And that means they could still spread it to innocent infants under one and pregnant women.  

The two dose schedule has nearly completely eliminated Chickenpox and its ravages.

Any misguided individual who speaks against routine use of vaccines such as Varivax, should be introduced to the families who have suffered tragic loss in the past from this now preventable unpredictable disease.