Chicken pox vaccine

[snowboarder]

Having read Louloulabelle's post re chicken pox...well it may be shallow of me but I don't know if I could bear 3 weeks of isolation and ill children. Does anyone have any enlightening info on the vaccine - I realise it is not offered as standard and would have to be done privately, but is it as effective as getting chickenpox in terms of future immunity? Why wouldn't you get it (finances aside....)? Just pondering...

[Ruth_Baldock]

I've considered it for myself and babies; never had CP and it would be bloody awful if I got it at the same time as them! I believe Saffron has posted about this before, think there is a place in Victoria that does it...

[damzel]

Yup, I definitely want my daughter to be immunised against CP. I've heard some horrible stories lately about how bad it can be. Couple that with a working family (one which doesn't get paid for time off and a child minder who still does!) I'm all for it. Trouble is, I've been pondering so long she'll probably get CP before I get around to researching where to get the jab. I shall be following this thread closely for clues... Is there anywhere nearer than Victoria that does it?

Edited to add that I believe the reason it's not offered on the NHS is because of the concern of an outbreak of shingles in adults which apparently is much worse (and you're protected from if you have CP but not from the jab). Feel free to correct me here as I'm blabbering from a vague memory of something I read in the dim and distant past.

[LI]

South London travel centre (in Myatts Fields) does this. It's the closest place I found. 2 doses needed so a couple of visits.

Did a lot of research at the time I was considering this for my son. I think the basic reason it isn't offered in this country is because of our bad take up of jabs. Adults get a little boost to their immunity when they encounter a child with CP. So either you need everyone having had CP or having been vaccinated so no CP in the community, or you need lots of children still having it to give the natural booster.

[KattyKit]

Hi,

Yes unless there was a two dose schedule with high coverage in childhood introducing it into the routine childhood imms program would result in an increase in shingles in older people as adults boost their immunity through exposure to chickenpox in children. There would be an increase in chickenpox amongst adults as their immunity waned - including pregnant women and women of childbearing age, which in turn would lead to an increase in infections amongst neonates (the fatality rate for babies whose mothers develop chickenpox around time of delivery is as high as 30%).

There is a quadrivalent measles, mumps, rubella and varicella vaccine licened for children under 12 but it s thought that introducing this would lead to a decline in MMR uptake. As measles, mumps and rubella can have more serious consequences the benefits of introducing varicella do not outweigh the risks of declining uptake. Also the two dose schedule would not be cost-effective for approximately 100 years!

There two vaccines licensed for use in the UK. The current schedule (I think) is one dose for under 13s and two for over 13s.

There are several private London clinic I believe which offer it. Obviously it is personal choice however it is the age-old what may benefit the individual could be harmful to wider society. If lots of people start to take it up privately then the scenario above would occur. Also, children who are vaccinated can get breakthrough infections which although milder are still infectious and would still require time off work etc.

So there is a strong argument that it is better all-round to develop naturally acquired immunity as a child.

Hope this helps (and isn't too rambley - v long night!!!)

[Saffron]

The argument that varicella immunization in children would cause a shingles outbreak in adults is not valid for several reasons. First, this hypothesis has not been definitively proved. Second, if this were the case, shingles in now highly treatable with antiviral drugs. And also, increased shingles in adults would only last a generation if children were vaccinated, b/c children growing up with the vaccine would of course have immunity as adults. This position would benefit society as a whole in the long run. The most obvious reason the NHS does not give the varicella vaccine is due to cost, sadly.

Natural immunity is not better than the varicalle immunization. They are comparable. Natural immunity does not necessarily prevent you from getting chicken pox a second time, and it is also not necessarily 100% life long. Any type of immunity will drop some with age.

As of Spring 2011, the immunization schedule for varicella was 2 doses not more than 6 months apart, followed by a booster in the early teenage years.

The Medi-Centre at Victoria does them privately for children over 12 months. It's best if you call to make an appointment. The cost is around ?100.

I have not heard of a quadrivalent valent vaccine including MMR and varicella. However, I did read research demonstrating that giving the MMR with a separate varicella immunization was linked to side effects, febrile seizures I think it was. Therefore the researchers' recommendation was that there should be some time elapsed (I think it was 1 month, I can look it up if you're interested) between MMR and varicella vaccination. In practical terms if your child's MMR is due, you need to let your consultant know that your child has had, or you're are considering giving your child, the varicalla vaccine.

I you've already been exposed, you can have the vaccine within 3 (?) days for 90%+ immunity, I think. Sorry, I can't remember, but it's in one of my original posts. I will try to look it up for you, b/c this was the information that I found after reading the original research papers for myself.

xx

PS: I'm not a 'vaccine nut'. (We actually didn't do the BCG for Little Saff, but that's another thread...) The above is my position after considerable research -- by which I mean looking at acutal clinical data, not just reading the pro/con websites.

[The Nappy Lady]

It is a tricky one. C hasn't had it yet & it is horrible having it hanging over us - mostly because I fear it will mess up a holiday etc.

Unless they have it really badly it isn't that awful & you can go out, you just need to stay away from other people - e.g. let them run around in Brockwell Park on the grass not the playground. The reason CP spreads like it dies is because the most infectious bit is 5-10 days before the spots come out when they are sneezing & the virus is airborne. Once they have spots they are infectious until the last one scabs over, but only by skin on skin contact.

Also playmates with other children who have already had CP are fine & pretty easy to arrange via the forum.

I plan to hold out and let C catch it naturally, just hoping it's at a convenient time!!

[KattyKit]

Hi,

Epidemiological modeling does show that varicella vaccine could lead to an increase in shingles - I remember attending a conference in 2008 which presented quite robust data.

You are right, Saffron, natural immunity is not 'better' than the varicalla immunization but in public health terms I have doubts about the benefit of sporadic unplanned uptake of varicella immunisation.

The vaccine is effective in preventing chickenpox or modifying severity 3 days (although can be given up to 5 days)post exposure - but in the case of prolonged contact with a case or if you are at risk of severe complications or pregnant then immunoglobulin is more effective.

I haven't seen the research re: doubts about the safety of the quadrivalent vaccine but would be interested in reading it.

[Saffron]

KattyKit Wrote:

-------------------------------------------------------

> Hi,

> Epidemiological modeling does show that varicella

> vaccine could lead to an increase in shingles - I

> remember attending a conference in 2008 which

> presented quite robust data.

Modelling is not the same as a proven hypothesis.

>

> You are right, Saffron, natural immunity is not

> 'better' than the varicalla immunization but in

> public health terms I have doubts about the

> benefit of sporadic unplanned uptake of varicella

> immunisation.

>

What doubts are those?

Whether or not you believe it benefits public health, the benefits to the individual are clear. Let's imagine for a minute a country where smallpox was still endemic. If an individual believed that sporadic uptake of smallpox vaccine was of no benefit to the public health of that country, would the individual still choose not to have the vaccine for him/herself and children before moving to that country?

Like I said, I'm not vaccine crazy. I don't think we should all rush out to get the latest immunizations just b/c they are available. What I am dismayed by is people making decisions for their children based on the argument "I had chicken pox and I was fine." This is not a safe or scientifically valid argument. By not immunizing, you must acknowledge that you are taking a risk with your child's health. If you choose to do so, it is your personal choice. That's fine. I do belive though, that people should have all the current data available accurately explained to them before they make that decision. Here I believe the NHS has fallen short, in failing to do so. Varicella is a standard childhood vaccine now in many other countries, sadly not the NHS in the UK.

>

> I haven't seen the research re: doubts about the

> safety of the quadrivalent vaccine but would be

> interested in reading it.

Was not to do with the quadrivalent jab, was to do with separate MRR + varicella immunizations. I will look for the article if I get a spare minute tonight. Might be in my old posts.

[Saffron]

Quote below is from the CDC. It's data from the USA. I think the data I originally read re seizure risk was European data, so I will keep looking for that. Nevertheless, this is interesting as a little different (not earth-shatterly so) to what I have read previously...

"Studies of febrile seizures after vaccination with first dose of MMRV vaccine have not been done in older children, but experts agree that this increased risk of fever and febrile seizures during the 5 to 12 days after first dose vaccination likely also occurs in children aged 24-47 months

"When the first dose of measles, mumps, rubella, and varicella vaccines is administered at ages 48 months and older [as opposed to children who received it at 12 months], use of MMRV vaccine generally is preferred over separate injections of MMR and varicella vaccines. [see the ACIP Recommendations.]Considerations should include provider assessment (including the number of injections, vaccine availability, likelihood of improved coverage, likelihood of patient return, storage and cost), patient preference, and the potential for adverse events."

http://www.cdc.gov/vaccines/vpd-vac/combo-vaccines/mmrv/vacopt-faqs-hcp.htm

[KattyKit]

Hi,

Saffron thanks for that I will have a look - seems interesting. I don't think I have explained myself very clearly (baby brain perhaps?!) I am very much 'pro' vaccinations and like I said in my previous post it is the age old case of what may benefit the individual may not been the best for society as a whole. I agree that parents should have all the information accurately explained to them and perhaps I am coming at it from a different perspective.

My doubts regarding sporadic uptake of varicella vaccination is that if on a wide enough scale could alter the burden of disease in the UK population; childhood vaccinations should be part of a planned public health programs with robust call and recall processes etc and that when we vaccinate we do it for benefits to the individual but also because of the wider herd benefits. What I am trying to say is that we need to ask ourselves is that while it may benefit our child is it actually to the detriment of child public health as a whole? I'm not saying I have the answer - I just think it is something to think about.

I am particularly concerned that low uptake of varicella vaccine (i.e via an unplanned program offered by private clinics) would lead to a increase in adult cases and we would, at least in the short term, see an increase in congential varicella.

I personally haven't seen any evidence that is convincing enough to unequivocally say that it would not lead to an increase in shingles in the older population and the JVCI position on this is also unchanged.

In a nutshell I guess I am saying that while it may benefit your child it may harm other children and adults and until it becomes part of routine imms (if indeed it does) we should hold off.

Interesting debate!

xx

[ClaireClaire]

Hello

Just to add to this to say I had my daughter vaccinated against cp at 2.5y

We had 1 jab at the Victoria MediCentre - cost around ?80 at the time, it was easy and effective.

I chose to do it because I was pregnant at the time and had not had cp myself previously... I hoped that by vaccinating my toddler, I would be less likely to come down with cp myself. (Which unfortunately was not the case, it still got me!)

Unfortunately I still have cp scars over 2 years later.... assuming my kids have the same type of skin as me, I would prefer for them to be vaccinated rather than develop cp and risk them having ugly scars for life! Just my personal preference.

Claire

[louloulabelle]

Hi

I think had i have known how nasty it can be i would have considered private vaccination but my two are only 2 1/2 yrs and 10 months so probably wouldnt have done it till nearer school age anyway but now they have had it so thats academic.

The older one had a fairly mild case, showed no symptoms of being unwell at all previous to the spots coming out, spots came out over 6 days and then about 4 for them to scab over completely, 4 weeks on shes still not clear of them and a couple sadly on the bridge of her nose look like they will scar.

Little one had a much worse case. She was very very unwell and was covered from top to toe with huge spots. No longer infectious but covered in scabs and red marks from where scabs have come away now so still looks poorly but shes much much better in herself.

I was told infection is highest 2/4 days prior to spots appearing and then all the way to the last scab appearing. Doc said its past through skin to skin contact, water and sharing toys they may have chewed, coughed or sneezed on so that goes for playgrounds where they touch the same handrails etc etc.

We did go out for the occasional walk where we wouldnt come into contact with anyone as they were in buggy and i was only housebound for 3 weeks as they got it back to back. We ventured out today to post office and over weekend they should both be fine for the park at last!!!

x

[bkkmei]

My 3 year old got chicken pox a few weeks ago. When it was clear what it was, I got myself vaccinated as I've never had chicken pox. An ex-colleague of mine had chicken pox as an adult and was laid up in bed, miserable, for 6 weeks! Perhaps there were additional complications for her, but the thought of all that misery, and I was straight down to the clinic (I went to Samedaydoctor in Wimpole Street - GBP95.)

So far so good, cross fingers I don't have chicken pox. My 10 month old has it now though!

[apenn]

Thanks for this post and reminding me that I should get my son vaccinated!

Not sure I buy the theory that the NHS don't offer it due to risk to adults - at least, this didn't prevent it from becoming a standard vaccination in the US. Suspect it has more to do with cost benefit.

-A

[anna_r]

This thread reminded me to get my second daughter done (one last week which is the first age they can have it) so we have an appt tomorrow at Victoria medicentre.

I have written about this before but can't find the thread. Our reasons were:

- My husband is from the states where it is routinely done as a vaccine

- didn't want to use all parental leave/holiday to take lots of time off work as we need hol to go and see grandparents in US

- I have chicken pox scars, didn't want daughters to have them

- sister in law got chicken pox the day before her wedding aged c28 as she never had it as a child which was a major inconvenience for all involved

These may not seem like significant reasons to some but together they convinced us in our situation.

I had it done for my first daughter at a Harley St clinic and she didn't even notice it, no tears, no disruption to sleep, no scars. Trying Victoria place as it's quite a lot cheaper I believe.

[Smiler]

The clinic we had it done at in surrey advise that for one-year-olds it's best to wait until a month or so after the MMR before having the chickenpox one.