Chicken pox vaccination or not?-Ask Dr. Paul Library

DEAR DR.PAUL: My family physician has suggested that we have our 18-month-old daughter vaccinated with the chicken pox vaccine. Is there enough information out there to support this recommendation?

PEDIATRICIAN DR.PAUL Answers: Chicken pox, caused by the Varicella virus, is one of the most common childhood infections. It is usually mild and not life-threatening to healthy children. However, it can be dangerous to individuals who have a weakened immune system, to adults and adolescents, and to babies less than one year of age.

The potential complications include bacterial infection of the skin, pneumonia, encephalitis (infection of the brain) and, rarely, Ryes syndrome - a severe and potentially deadly condition affecting the liver and brain. It is important to note that when adults get chicken pox disease it is usually more severe, often developing into pneumonia. Adults are almost ten times more likely to be hospitalised for chicken pox than children under 14 years of age. Adults are also 20 times more likely to die from the disease.

From a cost-to-society point of view, chicken pox can be expensive and inconvenient. Children miss school, parents have to miss work, causing inconvenience and a loss of productivity all around.

On the surface, the need for a chicken pox vaccine is a bit controversial, because most children with chicken pox do not develop any of the potential severe complications. However, it is clear that in some instances there are complications. For example, in the United States, about 9,000 people are hospitalised every year with chicken pox and about 90 people die annually with the disease.

These statistics, and the potential for complications, have prompted the American Academy of Pediatrics and the Canadian Pediatric Society to recommend the Varicella vaccination for children between 12 and 18 months of age who have not had chicken pox. They have also recommended a universal catch-up vaccination program for older children who have not yet had chicken pox. The vaccine has been proven to be quite effective in preventing the disease in the vast majority of cases. Obviously, this results in a decrease of potential complications.

As with all vaccines, safety is a concern. Before it became available to the public, more than 9,000 healthy children and more than 1,500 adults in the United States were tested with the chicken pox vaccination. The results have shown that the vaccine is safe. Only a few mild, temporary side-effects were reported including soreness, tiredness, fussiness, fever, nausea and a bit of swelling where the shot was given. Also, in a small percentage of people who were vaccinated, a rash may develop over the body. Since the vaccine became available in 1995, several million doses have been administered, with no severe side effects reported.

The bottom line is that chicken pox can be prevented by the Varicella vaccine which to date seems to be both very safe and very effective. However, it is also important to know that this vaccination should not be given to children with a weakened immune system.

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