Chicken Pox

Disease Definition

According to medical information, Chickenpox is a viral infection in which a person develops extremely itchy blisters all over the body. It used to be one of the classic childhood diseases. However, it has become much less common since the introduction of the chickenpox vaccine.

Most children with chickenpox have the following symptoms before the rash appears:

Fever
Headache
Stomach ache

The chickenpox rash occurs about 10 to 21 days after coming into contact with someone who had the disease. The average child develops 250 to 500 small, itchy, fluid-filled blisters over red spots on the skin.

The blisters are usually first seen on the face, middle of the body, or scalp
After a day or two, the blisters become cloudy and then scab. Meanwhile, new blisters form in groups. They often appear in the mouth, in the vagina, and on the eyelids.
Children with skin problems such as eczema may get thousands of blisters.

Most pox will not leave scars unless they become infected with bacteria from scratching.

Some children who have had the vaccine will still develop a mild case of chickenpox. They usually recover much more quickly and have only a few pox (less than 30). These cases are often harder to diagnose. However, these children can still spread chickenpox to others.

Chickenpox – the other side

Prior to the introduction of the chicken pox (varicella) vaccine, almost all children would have developed natural immunity to chicken pox prior to adulthood. Even if they did not have the symptoms of chicken pox, the chances are, they would have been immune.

Most ten-year-old children with negative or unknown histories of chickenpox are immune.

Boulianne N, Duval B, De Serres G, Deceuninck G, Masse R, Couillard M.

Institut National de Sante Publique du Quebec, Quebec, Canada. nicole.boulianne@ssss.gouv.qc.ca

To evaluate the proportion of children to vaccinate against varicella in a catch-up program targeting 9- to 10-year-old children, a study was conducted among children age 10 years to assess the age-specific incidence of varicella and document the immunity against varicella in those with negative or unknown chickenpox history. Of the latter 62% were seropositive for varicella.

PMID: 11734718 [PubMed – indexed for MEDLINE]

Pediatr Infect Dis J. 2001 Nov;20(11):1087-8

Healthy, well-nourished children who contract chicken pox in childhood tended to have no long-term sequelae other than a few small scars. Indeed, since the symptoms of chicken pox can be more severe if contracted in adulthood, it was always considered preferable for children to contract the disease and develop natural immunity in childhood.

At the time when the licensure of this vaccine was being debated, Dr. Phlllp Bru¡¡ell, head of paediatric infectious disease at Cedars Sinai Hospital in Los Angeles was cited in the New York Times (July 7, 1993) as saying that in order to justify giving all children a vaccine for a disease that is essentially harmless, the vaccine must be totally risk-free. And yet, this vaccine can in no way be described as risk-free.

Dr Arthur Lavin from the Department of Pediatrics at St Luke’s Medical Centre in Cleveland Ohio write in The Lancet that there are three concerns which he believe argue strongly against the licensure of varicella vaccine for healthy children:

1- chickenpox “is not major in the sense of disease mortality or morbidity. In childhood, mortality is very low and morbidity is usually minor…”

2- routine chickenpox vaccination in healthy children might pose a “grave danger” of advancine the age of onset of chicken pox into adulthood” which is exactly what happened in Japan, the first country to introduce routine varicella vaccination.

3- Dr Lavin had serious concerns about the long-term genetic effects of “injecting millions of young children with a mutant strain of [live] herpes virus. …Although the risk of deleterious effect is remote, the application of this risk to hundreds of millions of [individuals] increases the chance that we will see some adverse effect.

At the time when Australia was considering introducing the chickenpox vaccine to our schedule, the determining factor was not whether or not this shot would save lives because it was readily admitted that this was not a deadly disease. Instead, the main motivation behind the introduction of the varicella vaccine was purely economic. If the illness could be prevented, mothers would not have to stay home to take care of sick children, saving the country more money then the cost of the vaccine.

Direct and indirect costs of chickenpox in young children

MJ FERSON, WL SHEN, and A STARK

J. Paediatr. Child Health (1998) 34, 18-21

Chickenpox generally is a mild illness in otherwise healthy children, with pneumonia, encephalitis and acute cerebella ataxia occurring as rare complications. Traditional management of children with chickenpox attending childcare requires that they be excluded as soon as the diagnosis is made. Therefore the costs of chickenpox in young children using care outside the home must not only include the costs of medical care for the illness itself. The substantial costs of missed care, foregone earnings of parents required to care for the sick child and/or payment for alternative care arrangements also need to be taken into account.

Shingles

Shingles is an acute infection caused by the herpes zoster virus, the same virus that causes chickenpox. Prior to the introduction of the chickenpox vaccine, Shingles was most common after the age of 50 and the risk rose with advancing age. Shingles occurs because of exposure to chickenpox or reactivation of the herpes zoster virus. The virus may remain latent (dormant) in nerve roots for many years following chickenpox or chickenpox vaccination.

Shingles is an extraordinarily painful condition that involves inflammation of sensory nerves. It causes numbness, itching or pain followed by the appearance of clusters of little blisters in a strip pattern on one side of the body. The pain can persist for weeks, months or years after the rash heals and is then known as post-herpetic neuralgia.

People with shingles are contagious to persons who have not had chickenpox and can catch chickenpox from close contact with a person who has shingles. Treatment includes antiviral medication and pain medication.

Whilst it used to be very rare for a child to get shingles, today, we are seeing increasing numbers of children contracting this painful and potentially disfiguring condition due to their having been vaccinated against chicken pox. In fact, it is now possible to get shingles without ever having had a previous chicken pox infection due to the use of the live-virus varicella vaccine.

Vaccine side effects

The most common side effects reported after varicella vaccination are fever and soreness at the site of injection. Others include a chicken pox like rash (1-3%), abdominal pain, cold-like symptoms, cough, diarrhoea, nausea and sore throat.

Rare reactions include black, tarry stools; blood in the urine or stools; confusion; difficulty in breathing or swallowing; hives; irritability; itching, especially of feet or hands; muscle or joint pains; pinpoint red spots on skin; reddening of the skin, especially around ears; severe or continual headache; stiff neck; swelling of eyes, face or inside the nose; swelling of the glands of neck; unusual bleeding or bruising; unusual tiredness or weakness; sudden and severe vomiting.

A VAERS (Vaccine Adverse Events Reporting System) search conducted on April 1, 2012 showed that there were 60,913 reactions reported to both varicella (chickenpox) and varicella zoster (shingles) vaccines. 543 of those reactions were considered life-threatening, 169 led to death and 6,342 had not recovered from their reaction as of the date of reporting.

VAERS collects less than 10% of all reactions, meaning that the numbers would be far higher then those above

DATA SHEETS

Sourced from: www.medsafe.govt.nz

Similar to ‘Package Inserts’ these Data Sheets contain information provided by the vaccine manufacturer and list, among other things, the vaccine’s ingredients and possible side effects.

The AVN had the up-to-date Australian vaccination information on our website for years. Unfortunately, we were ordered to remove these details due to supposed copyright issues though they are freely available across the Tasman as you can see.

As far as we are able to determine, this information and the vaccines are exactly the same as the information and vaccines used in Australia. The most important information for you as a parent or a health professional is the vaccine ingredients, what the listed side-effects are and the contraindications (or reasons why the vaccine might not be appropriate for everyone).

Information on Vaccines used in the USA can be found here: http://www.vaclib.org/chapter/inserts.htm

Please share the links to these pages with anyone you know who is considering vaccinating their children or themselves.

Varilix Vaccine – Monovalent varicella vaccine –  GlaxoSmithKline – Data Sheet

Varivax – Varicella Virus Vaccine Live – Merck, Sharpe and Dohme – Data Sheet

Priorix Tetra – Live attenuated measles, mumps, rubella and varicella vaccine – GlaxoSmithKline – Data Sheet

ProQuad – Measles, Mumps, Rubella and Varicella Virus Vaccine Live – Merck, Sharpe and Dohme – Data Sheet

Zostavax – Zoster Vaccine Live (shingles) – Merck, Sharpe and Dohme – Data Sheet