January 22, 2018
This piece was originally published on Dr. Merrill-Steskal's blog, Triple Espresso.
John Merrill-Steskal, MD
A bacterial skin infection results in the blister rash characteristic of active chickenpox.
Kids love parties and play-dates, and parents enjoy both organizing them as well as socializing with each other as their child is joyfully engaged with friends. After a high energy afternoon of play and socializing, parents and children return home to recover and begin the next day anew. It is a story repeated every day across America- a happy story.
I would like to address a different kind of party, the "chickenpox party," where parents bring their children together in order to expose them to chickenpox, an infectious disease caused by the varicella virus. While the party begins the same with the theme of happy kids and socializing parents, it has a different ending in which children return home to later develop chickenpox.
The rationale behind a chickenpox party is that by experiencing the natural disease, a child develops natural immunity to the virus, which some feel is better than immunity from the vaccine. While this reasoning may seem appealing, please consider how the decision to join a chickenpox party can impact the health of your child as well as others in your community.
When a child - or a person of any age for that matter - has active chickenpox, they experience a disease. Chickenpox can sometimes be mild, but is typically a moderate illness that lasts one to two weeks and is characterized by fever, headache, fatigue, and a rash of blisters that covers the body. Most children who have the infection miss 5-6 days of school or daycare. When a child receives the vaccine, they do not suffer from the disease.
Complications of chickenpox can be serious. The most common complication of chickenpox is a bacterial skin infection, which at a minimum requires antibiotics. When the bacteria enter the body through one of the many ruptured blisters to cause a bloodstream infection, children need hospitalization for treatment. Meanwhile, the leading cause of death from chickenpox is pneumonia and a brain infection called encephalitis. Before the advent of the vaccine in 1995, 10,000-12,000 children were hospitalized and 100-150 children died every year in the United States from chickenpox.
There are people in every community who are vulnerable to serious complications from chickenpox, such as babies, pregnant women and people with a suppressed immune system. Infants less than a year old are at an increased risk of severe disease, and since children are not routinely vaccinated until a year old they are vulnerable during this first year of life. In addition, varicella infection during pregnancy can be devastating to the developing fetus, causing birth defects and miscarriage. And lastly, a person with a suppressed immune system is at high risk of severe disease or death from varicella infection. Immunosuppression is increasingly common in medical care these days as people receive immunosuppressive medications for cancer, Rheumatoid Arthritis, or Crohn's Disease for example.
The varicella vaccine is 90% effective in preventing chickenpox, and immunity (protection) is typically long lasting. While it is possible to get chickenpox despite having received the vaccine, when this happens the infection is very mild. Of profound significance, the varicella vaccine is 100% effective in preventing serious complications and death from chickenpox.
The natural course of varicella infection is such that following the initial infection, the virus lays dormant throughout one's life. If the varicella virus reactivates in adulthood it causes "shingles," which is a localized, painful blistering rash. A third of adults experience shingles during their lifetime. Almost as a special bonus to receiving the vaccine, research has shown that those vaccinated with the varicella vaccine tend to experience a milder case of shingles in adulthood compared to those who have had the "natural" infection.
A party to spread an infectious disease that could otherwise be prevented by a safe and effective vaccine is not my kind of party. Instead, my suggestion for a chickenpox party is to have a party to celebrate the vaccine and good health. Bring your vaccinated kids, have a great time, and go home without disease and suffering. Share happiness and health with each other rather than a viral infection. This is the type of happy story medical practitioners hope to see within our communities, as well as across America.
*Opinions expressed by KVH Contributors are their own. Managed by Kittitas Valley Healthcare, HealthNews does not provide medical advice. For medical advice, please see your healthcare professional.