Once ubiquitous, then obscure, chicken pox parties are enjoying a resurgence. The goal: To expose unimmunized children to the highly infectious illness — sooner rather than later. “Natural chicken pox” proponents who are anti-vaccine, believe catching it in early childhood — and benefiting from lifelong immunity — is safer than contracting the illness during adolescence or adulthood, when symptoms and complications can be more severe. But pediatricians say the chicken pox vaccine is safer. One new study even recommends kids get a second dose of the vaccine to vastly improve immunity.
Should your child get vaccinated (possibly for the second time)? Or should she hang out with a sick buddy?
Chicken pox is caused by the varicella-zoster virus. The virus is spreads easily through contact with the sores or through the air when a person infected coughs or sneezes. It starts with fever and leads to dozens, even hundreds, of itchy red spots that turn into blisters before crusting over. All told, the typical case lasts seven to 10 days. For most kids, it’s no biggie.
But in rare cases, chicken pox leads to terrible complications, including bacterial soft tissue infections, hepatitis, pneumonia, stroke and encephalitis (inflammation of the brain). Varicella increases the risk of severe invasive group A streptococcal infections in previously healthy children by 40 to 60 times. The bacteria can result in mild impetigo or strep throat or, in a small number of children, necrotizing fasciitis (“flesh-eating disease”) or Strotococcal Toxic Shock Syndrome, both of which can be fatal.
Are these worst-case scenarios common? No. But possible? Yes. The majority of chicken pox-related hospitalizations involve previously healthy children, so even if your kid has a strong-like-bull constitution, the unthinkable could happen.
“We have a perfectly good vaccine, so it doesn’t make sense that parents would want their child to have a disease that has consequences and can cause death, rather than get a shot that will prevent it,” says Dr. Robert Bortolussi, a Halifax-based pediatric infectious diseases clinician and Chair of the Canadian Paediatric Society’s Infectious Diseases & Immunization Committee. Potential vaccine side effects are temporary, including soreness at the injection site, mild fever or, occasionally, rash.
Vaccine critics don’t take issue with these side effects, but they question its efficacy: “We don’t know when the vaccine’s effectiveness runs out. Let’s say you have to re-vaccinate every 10 years: if you’re very vigilant about this, your child probably won’t get chicken pox later. However, most people are busy: they forget. The danger is your child could catch chicken pox in adulthood or be put at a greater risk for shingles,” says Sonya McLeod, a homeopath in Vancouver. In adulthood, chicken pox can lead to severe problems in pregnant women, including stillbirths, birth defects, or infection of the newborn.
Most kids in Canada are vaccinated at 12—15 months, but one-dose vaccination is possible up to 12 years of age. Those 13 and older will need two needles, four weeks apart. A recent study published in the Journal of Infectious Diseases suggests that a booster dose, even years later, vastly improves protection. If your child was vaccinated as a toddler, you may want to consider a second shot when she starts kindergarten or Grade 1, says Dr. Bortolussi. McLeod says she plans to send her children, now six and seven, who were vaccinated as babies (“I wasn’t as educated about the issue as I am now”) to chicken pox playdates.
Some infants and kids shouldn’t get the varicella vaccine because of underlying problems. They include those with compromised immune systems or chronic inflammatory diseases, as well as recent organ, blood or bone marrow transfer patients. It’s for these children that society should aim for mass varicella vaccination, says Dr. Bortolussi.”Our goal is to minimize the amount of natural chicken pox virus because some people are more susceptible to its effects, particularly people undergoing chemotherapy or who have immunological problems. When you hold a chicken pox party and infect more children, you’re creating real risk for people in the community who can’t be vaccinated because of their immune system. If these people catch chicken pox they may end up needing anti-viral drugs, hospitalization or even intensive care,” says Dr. Bortolussi.