Chicken Pox Vaccine

[kiyoaki]

Hi there

I have decided to get my children vaccinated against Chicken Pox (a friend of mine has just come out of hospital after being very poorly with it) and have found it quite difficult to find anywhere that will do it so thought I'd post details of the South London Travel Centre in Camberwell as I know there have been numerous posts on this.

Cost is ?65 a vaccine and you need 2 doses.

Medicentre at Victoria Station used to offer vaccine but they have lost their paediatrician so no longer doing it; the London Paediatric Group on Harley Street does it but there is only one consultant doing vaccines so hard to get an appointment; there is another place on Harley Street www.childrensimmunisation.com but you need to pay ?50 a child to even register when them, then pay a lot more than ?65 for each vaccine.

South London Travel Centre

Akerman Medical Practice,

2nd Floor,

Akerman Health Centre,

Patmos Road,

London

SW9 6AF

[etta166]

The GPs at the Elm Lodge Surgery will also give the chicken pox vaccine, on the NHS. My husband had it there last year.

[prdarling]

Do bear in mind though that chicken pox is usually much worse in adults than children. It's a nasty business for a grown up but it usually doesn't affect children for more than a few days and in many cases can be really mild....

[Saffron]

Relatively mild compared to what? The course of chicken pox is potentially more complicated than mumps. Chicken pox, even in healthy children, can lead to auto-immune encephalitis. And the generally help rule that chicken pox is worse for adults than children has many exceptions.

That the NHS has failed to universally offer immunisation against varicella is due to a complex list of reason, very few of which are actually medically based.

The US CDC website pages are a decent resource for more information on the vaccine itself and vaccination schedules.

[buggie]

Saffron & I have differing (but respectful of each other) views on this.

This is a post I made previously when the subject came up previously:

(http://www.eastdulwichforum.co.uk/forum/read.php?29,1009595,1010063#msg-1010063 - on iPad again so can't do links :( )

The majority of cases are fine though and not on par with measles/meningitis C/B.

In 13yrs working in acute paediatrics I can still count on one hand the number of cases of CP related pneumonia I've seen (all of which needed admission to ward not to intensive care & each made a full recovery), no cases of CP related encephalitis. From the same abstract [saffron linked to on the prev thread] rates of complications leading to death related to CP are 1 in 40,000 cases whilst for measles that is 1 in 15 notified cases (cases of measles have to be reported to the local public health department). (http://www.hps.scot.nhs.uk/immvax/measles.aspx - can't link on iPad!).

[Saffron]

If people don't want the CP (or other vaccines) it is their right not to do so, which I respect. However, I've come across many parents who would have had their children vaccinated against CP, but they were not aware that a vaccine is available.

I'm disappointed that not only does the NHS not offer it, but it doesn't even try to make parents aware of it -- and I do find that hard to respect -- Especially, as I stated previsously, the reasons for not doing so do not appear to be medical. Despite the fact that most children will make full recoveries from CP complications, they would indeed not have required hospital admission at all if they had been vaccinated. If the medical oath is to do "no harm", the NHS in its medical capacity does parents a disservice by not offering, and not making parents aware of, the CP immunisation.

http://www.cdc.gov/chickenpox/vaccination.html

http://www.cdc.gov/vaccines/vpd-vac/varicella/unprotected-story.htm

[SuzieK]

My little one (6 months old) has just had chicken pox and you wouldn't have known. I also have 8 nieces and nephews all of which have had CP and none of them have had complications but the older the were the harder it was with the scratching more than anything.

I have also had an uncle who had CP as an adult and he was terribly ill so have have seen first hand that CP is 10 x worse as an adult than as a child.

I do agree though that parents should be made more aware of the option of a vaccination but also feel that it shouldn't be pushed as the illness itself is not a risky one for children unless you have a weakened immune system.

[Kate08]

Saffron / Buggie

I am quite interested in the chicken pox vaccine, but the little research I have done seemed to suggest that there is an increased risk of shingles as a result of the vaccine. I am not clear if the increased risk is to the person who has the vaccine or to society as a whole.

Would be interested to hear your thoughts on this?

[buggie]

Think it's going to be difficult to find much evidence on is either way as its a relatively short amount of time (since 1995) that the vaccine has been licensed. But this:

http://articles.mercola.com/sites/articles/archive/2010/11/02/chicken-pox-vaccine-creates-shingles-epidemic.aspx

Would indicate that there is a growing problem with shingles, as well as highlighting that it has been entirely in the drug companies interest to over-emphasis how much of a problem varicella viruses caused and that the increased cases of shingles could give them a ready made market for further medications.

Would be curious to see Ben Goldacre's take on varicella immunisations, but think he's busy taking on the big pharmaceutical companies!

[KattyKit]

Hi,

Yes one of the reasons for not introducing universal chicken pox vaccine was the evidence that it would lead to increase in shingles in older people (however this will now be reduced due to the introduction of a shingles vaccine) and more importantly an increase in congenital varicella. This is because introducing a universal cp vaccine will significantly alter the epidemiology of the disease and result in a much later average age of infection amongst unvaccinated people ( which could be as high as 30% of the population) this would result in more severe infection and an increase in the number of pregnant women contracting the disease, hence the increase in congenital varicella.

Like buggie I can count the number of cp related complications I have seen on one hand. It is generally a mild disease and complications are very rare.

[etta166]

I appreciate the points that you've made, but essentially what you are saying is that the NHS chose not to introduce a CP vaccine universally (so with the potential to cover 100% of the population) because people who choose not to have it would put themselves at risk of catching chickn pox late in life. That seems a bit unfair on those that would vaccinate themselves or their children, that they should have to accept the risk of (very rare) complications so as to protect the health of someone who declines to have the vaccine...

Also, is the increase in the incidence of shingles from shingles in vaccinated or unvaccinated individuals who have had CP?

[Mens]

I wish I had known where to get the vaccine a year ago!! I asked GP for it but was refused.

DD1 had severe CP, DD2 had mild CP and DD3 was hospitalised with encephalitis several months later and it was suspected that it was due to CP complications (although not confirmed).

I guess having vaccinations or not is a gamble. When she was ill recently the consultant said that it might be due to complications with the flu vaccine and I also read research recently that severe allergies might be cause by vaccines.

Who really knows????

[TE44]

That must have been a nightmare for you all mens. I hope your little one

recovered.

I agee,"who really knows". Considering the

studies showed the link from swine flu vaccine, 2009-2010,sorry can't put up link now.

And narcalepsy recently, also conflicting info, although

all remaining vaccines to be destroyed. There many factors

in our enviroment, food, water etc. Which may play a part,

In our health, which to a degree, we have a choice. I

believe this choice should remain regarding vaccines.

[Sol]

Thank you for the information. I have been thinking of immunizing my 2 year old child; the first one had it when he was 9 months and even though there were no complications it was very hard for 3 weeks and then my husband got infected too even though apparently he had it when he was a child; Why do so many other countries in Europe offer the vaccine and not the UK? Are those countries putting the adult population at risk of getting shingles? I doubt it.

[etta166]

I wonder if the reluctance to introduce another vaccine into the childhood vaccine timetable has anything to do with the MMR scandal? Many countries including the US give the chicken pox vaccine as part of the MMRV - the MMR + the varicella vaccine. I don't think that would go down very well in some circles in the UK.

The WHO guidance is that the risks associated with contracting chicken pox are greater than the risks of vaccination, so it recommends infant vaccination against the disease. I am tempted to get my children vaccinated if they don't catch it this winter.

[apenn]

FYI children under 12 mos can't be vaccinated for chicken pox.

-A

[Saffron]

etta166 Wrote:

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

> I wonder if the reluctance to introduce another

> vaccine into the childhood vaccine timetable has

> anything to do with the MMR scandal?

Yes, it is a legacy of the Wakefield scandal. The NHS openly admitted that public trust in the vaccination programs was also a major problem/concern when recently introduing the whooping cough vaccine, and it is also probably one of the reasons holding back routine administration of the shingles vaccine. So even though the NHS robustly jumped on the anti-Wakefield bandwagon (and rightly so), it is nevertheless allowing itself to be manipulated by his legacy.

The chicken pox vaccine can and does save lives and prevent hospitalisations (as does the shingles vaccine). If people don't want their children to have the vaccine I do totally and fully respect that. However, since a safe effective vaccine is available, the NHS should provide parents with the choice. As it is, people who can't afford the vaccine are unfairly punished in this.

The argument that administering CP vaccine universally across the UK would result in an increase of shingles cases can be easily negated by simply offering adults (who have previously had CP) the shingles vaccine, which safely and effectively reduces the incidence of shingles and its severity.

We can talk statistics till the cows home, but it's not totally about numbers, is it? Let's face it, people play the lottery --presumably hoping to win-- on stats much narrower than those for the complication rates of CP.

CP and CP-related complications are not just about statistics. They're about biological relevance. As an esteemed colleague of mine says, "How many times do you have to cut the head off a chicken to prove it's dead."

So my point is, that even though it's rare, children do die of CP. The statistics may not seem impressive, but to the parents of that dead child, the statistics hardly matter do they? Would you tell those parents that they're "over-emphasing" the issue?

I also find it illogical to say that just because hospitalised children make a full recovery, that we don't need to be concerned with preventing their hospitalisations in the first place. For example we don't say that because most people recover from car crashes that we won't try to prevent motorway collisions. And we don't say that because children with broken bones usually heal with no permanent damage, so we won't try to prevent broken arms.

That mercola link is 3 years out of date, and it's the first thing that pops up on Google when you enter 'shingles epidemic'. Hardly what can be referred to as well-researched. I'd be happy to read what Ben Goldacre has to say about it, if he'd care to publish it in a peer-reviewed journal.

After reading the facts for themselves, not everyone will choose to take the CP/shingles vaccines, but they should at least be made aware of their availability.

The CDC webages are a good source of information on both CP and shingles. This non-scientific article also provides good summary information, along with the citations for three recent journal articles from JAMA and the J of Int Med: http://www.examiner.com/article/increasing-incidence-of-shingles-is-easily-preventable-vaccinate. xx

[buggie]

You're right Saffron, it wouldn't be the first result if googling "Shingles Epidemic" as that is a broader term not looking specifically at a link to varicella immunisation (as I was)

I found it interesting as it gave me context on the numbers of cases of chickenpox/cases of complications from prior to the jabs introduction - important for when weighing up the risks of the virus.

It is down to each individual what they would want to do, but tire of what feels like scaremongering whenever the subject of chickenpox comes up. I'm afraid I haven't had chance to look into every piece of research on every aspect of the varicella immunisation, (funnily enough it doesn't seem to be something my colleagues have been commonly asked about) but have been seeing & advising parents in RL on caring for children with CP for 14yrs to be sure the statistics suggesting rates of complication are v v low are accurate.

Although things shouldn't come down to money, the nhs is forced into a corner financially by the government and if clear proof of the cost of the immunisation wouldn't lead to a greater saving on GP/A&E/hospital care (which I doubt it would) I don't think it will be adopted.

[TE44]

Hi Buggie, my neices son (3yrs old) has been diagnosed

as having shingles, he has no other health problems.Have you come across many cases

of this in children. I have never heard of it before. On googling,

Info i've found says its very unusual and normally children with other health

problems get it. Can't find any figures on cases of this in chilldren.

[buggie]

I haven't seen it/heard of it before, but understand it can happen - more likely apparently if they had chickenpox under a year or the varicella vaccine - am unsure even of the stats of

If it is it'll follow along a nerve route which would mean the rash was only in a particular part & side of the body & not widely or evenly distributed across the body. Would have a low threshold for getting him checked again if it didn't seem typical to this. Poor lamb though, hope he feels better soon.

[TE44]

Thanks buggie, its around his stomach/back. My neice says he has never had cp

before but his older brother had it. My sister has worked with pre school

children for years and she'd never heard of it either.

[kareen]

My son caught Chicken Pox from my daughter when he was just 6 weeks old. Knowing what I do now I would have had her vaccination in America before I had him because what most people don't know is that CP can be potentially serious in newborns. Luckily he did not have it so bad and he was regularly checked by his doctor. I have never had CP as a child but was vaccinated with The MMR and The Varicella vaccine when I was at university. I can honestly saw I am glad I was.

[KalamityKel]

it is incredibly misleading to assume that once you've had a "vacination" against anything that you are 100% immune to that illlness. it can only help build a resistance to the illness. there is still a chance of getting ill.

in the case of chicken pox i would like to point out its assumed you only get it once and then other types are of the shingles varierty... this is not true either. as a baby i had chicken pox - quite severe - and then a few years back i contracted it again but only a few spots. it was definately not shingles.

just goes to show that trends are not the definitive answer.

i would like to see parents given better information in general about illnesses, their implications and options available.

[etta166]

As well as being potentially more risky in newborns/babies, when my little one was exposed at 4 days old I was also told that if she did catch it she would not get any long lasting immunity from it. That might explain why KalamityKel, you had CP twice. So did my Dad, as an infant and as an older child.

As to immunity from a vaccine, no vaccine makes 100% of the people who have it immune to the disease it protects against. CP vaccine is thought to be about 86%-96% effective if you have two doses 3-12 months apart.

Another interesting thing I was told about vacination in general is that as mothers, we are all told that if we BF we pass on our immunity to certain diseases to our newborns (including CP, measles etc) but that this is all based on studies of women who had the illness not the vaccine. It's not certain that the same is true for women like me who had the MMR. I thought that was very interesting.

[Saffron]

Yes, there have been studies in both vaccinated and previously-infected women. Although, obviously, cross-generaltional studies are still relatively new in humans, as modern immunisations have only been available over the past century.

My understanding is that immunisation/infection lead to the production of IgG antibody-mediated immunity (against the specific virus or specific viral elements of the vaccine, which is why vaccine-mediated immunity can differ from infection-mediated immunity), some of these specific antibodies are transferred through breast milk. This may be lower for vaccinated mother's compared to those having been previously infected.

However, in either case, this confers a temporary, partial, passive immunity. It does not "vaccinate" the infant against the specific disease, although it does confer significant temporary protection. Furthermore, specific IgG antibodies are not transferred in large quantities to breast milk. Instead, non-specific IgA antibodies make up the bulk of immune antibodies in breast milk, of both vaccinated and non-vaccinated women.

KellyMom does a good job of making a short summary of this info here: http://kellymom.com/bf/can-i-breastfeed/meds/vaccine-protection/ . This article from J of Pediatrics focuses on measles but is intresting and relatively easy to follow http://www.sciencedirect.com/science/article/pii/S0022347686810393 .

Undoubtedly CP/shingles imms in the UK are an issue of finance as well as public trust. Truly comprehensive vaccination would probably require children to be re-vaccinated as adults. Indeed, it may be more expensive to administer the imms in the short term, but in the long term this would save money by saving hospitalisations and meds/care related to complications in both CP and shingles in children and adults. (However, even if there is no net savings, I would still personally believe that the role of the NHS should be to invest in health and preventative medicine, not just to treat the sick.)

It's not scare-mongering to offer people information of CP imms, as appears to be the OP's intent by posting information about the South London Travel Clinic in Camberwell. S/he says only that s/he was influenced by his/her personal experience, and offers readers information about cost comparison. Indeed the first comment to be made about the course of the disease was not by someone scare-mongering, but by someone downplaying it.

Why not simply give parents the facts, and let them decide for themselves? If the NHS is not routinely going to offer CP/shingles vaccines, it should at least be making people aware of them, imho. While it's wonderful to reasure parents of sick children that CP generally has an uncomplicated course of progression, what we should be telling parents of healthy children (and our vulnerable elderly populations) is that vaccines are available.

I can absolutely respect the choice of individuals not to vaccinate, if after having read and understood the risks either way, they decide that it's not something they want to undertake. I find it harded to accept that information about CP/shingles vaccines is not being made widely available to the public through the NHS. Do we want an NHS that runs mainly on a patch-and-repair principle, or do we want an NHS that invests in comprehensive preventative medicine for generations to come? I believe that in order truly to give parents a voice in this, they also need to be given the opportunity of informed choice.

Thanks very much to the OP for the information provided. xx