To think it should be free and part of the childhood vaccines?

[CottonCandy01]

Hello,

My friend's son is getting his chickenpox vaccine next week, I believe it is costing around 140-150 pounds for the two doses. It got me thinking about my own young child (currently 6 months) and if this is a path I should take - on balance, i think I will get it for her.

The problem I have with this, is after researching why we don't have it as part of the childhood vaccines here this is what it returned:

*So why doesn’t the UK use the chickenpox vaccine for children if it is safe and effective at preventing severe disease? All vaccines in the UK are assessed for their cost-effectiveness to ensure that the health budget spent on services which provide the greatest health benefit for the population as a whole.

In the last review of the chickenpox vaccine by the committee which advises the government on vaccines (the Joint Committee on Vaccination and Immunisation, JCVI), the future modelling of the impact of vaccination indicated that there could be an increase in the rate of shingles in adults over time, which would make the vaccine programme not cost-effective.

This is because, if chickenpox in children disappears as a result of a vaccine programme, adults would no longer have their immunity boosted by exposure to their chickenpox-suffering children and grandchildren and would be more likely to get shingles. Put simply, the conclusion of the previous review was that it would not be cost-effective for the NHS to immunise children against chickenpox*

So if I'm reading that correctly, it is basically because we can't afford it? I'm not naive or an idiot, I know the NHS is hideously underfunded but I just think it is so wrong. I'm in a privileged position that I can afford to vaccinate my child, as can my friend, but for those who can't I think it is really crappy. Chickenpox is not always a mild disease, it doesn't look like something that should even be in circulation in 2021, I remember my younger siblings, crying in pain all night and hitting temps over 40, one of them had to go to hospital.

Not sure what my AIBU is here but I just can't believe it isn't part of the vaccination schedule over here when it is in so many other countries. Seems so wrong.

It’s not only about the cost though but shingles as an adult is awful.

Basically, our unvaccinated children act as innoculators for us against shingles.

From some of the research I have done, according to data that is coming out of the other countries the shingle argument doesn't stand up quite as much as first thought. It is being reviewed apparently. The meningitis jab i don't think was free until 2015? I can imagine this one possibly going the same way. I hope so anyway.

For the most part chicken pox is a mild illness. It’s interesting that since the more severe illnesses, measles, rubella, smallpox etc have been eradicated/reduced we seem to need to paint illnesses such as chicken pox as serious.

Yes, there are always going to be children who are severely affected by CP as with any illness, but they are in the minority, and it is far better for children to catch chicken pox naturally.

but if that is the case, why is it part of the childhood vaccines in many other countries? the US, Germany, NZ etc?

I personally don't think it's necessary to vaccinate against chickenpox. It is not life threatening and is good for the immune system to be able to battle some things naturally.

YANBU. It makes no sense at all. I was fully prepared to pay for DD to have it after her 1 year jabs but lockdown happened and then she got chickenpox anyway, literally no idea where from, and it was pretty mild. Two weeks later it came back, even less idea about that either, GP was flummoxed.

YANBU

The shingles argument definitely doesn’t stack up now that there is a vaccine against shingles.

I have just found this online too, an interview wtih Professor Judy Breuer, professor of virology and head of Division of Infection and Immunity at UCL. It is quite long but the interesting part:

Despite previous concerns, it is now thought that the risk of shingles to the adult population may have been overestimated.

"There are questions now as to whether the modelling has overestimated the amount of protection that you being exposed to your child's chickenpox will give you. Some countries have now decided that they don't think the shingles risk is as large as was thought," explains Breuer.

"The whole of Canada, the USA, Australia and New Zealand vaccinate, as well as several countries in Europe. There are lots of places that do now vaccinate against chickenpox because they don't necessarily think that the story about shingles is going to hold up."

"The UK is now revisiting the modelling to see whether the modelling that has been done in the past really does reflect the reality."

Hopefully it will soon be free to all, not just those who can afford it :(

My DP has battled through every illness and medical problem he's had (inc back pain so severe he could not walk upright, yet still went to work). Shingles floored him. I have never seen him so ill.

If chickwnpox in children means a greater resilience to shingles I'm all for it.

@CottonCandy01

but if that is the case, why is it part of the childhood vaccines in many other countries? the US, Germany, NZ etc?

Because they have a very different health care system. You can have anything you want in the US providing you pay for it. When healthcare becomes a money making exercise it doesn't become about doing what is right and works but about what gives the most profit

No, I don't. It can wear off and then people could catch it as an adult etc and become more ill than they had been as a child.

There is a shingles vaccine though...so again, it is all about costs presumably. Like I said, seems wrong. Shouldn't have to roll the dice with our health when there is working vaccines out there. Like I said I'm lucky, I can afford vaccines but plenty can't.

I'm fairly neutral on this and find I can be swayed either way quite easily by the pov of whoever is talking about it at the time. Overall, I lean mostly towards wanting to reduce the risk of shingles because I have not known anyone to have that and not be in real discomfort: like most of us I have seen thousands of children have chicken pox and only one or two be really unwell with it. But yeah, I can see the argument both ways. I didn't vaccinate my dc- my eldest had it and was fine, my middle and younger children have been exposed to it +++ but never caught it, same as my mum who also seems immune. I remember having it but my DH has no idea whether he ever did.

I think it's a cost benefit thing. I dont think there are more issues with shingles in older adults in other countries where it has been routine for many years. And its routine in many other countries in the EU where healthcare isnt run by 'big pharma'. Yes immunity wears off but people can just get a booster

My understanding is that it was going to be added to the vaccination schedule, but then the Wakefield/autism stuff happened, and it was pulled for political reasons. All mine were vaccinated privately.

I will be vaccinating my son against chickenpox if possible- planned to vaccinate my daughter but she caught it at 11 months anyway. Reason being that, although it's low risk, it's still a risk. From the Centre for Disease Control:

'Serious complications from chickenpox include:

Bacterial infections of the skin and soft tissues in children, including Group A streptococcal infections
Infection of the lungs (pneumonia)
Infection or inflammation of the brain (encephalitis, cerebellar ataxia)
Bleeding problems (hemorrhagic complications)
Bloodstream infections (sepsis)
Dehydration
Some people with serious complications from chickenpox can become so sick that they need to be hospitalized. Chickenpox can also cause death.'

@Sirzy

It’s not only about the cost though but shingles as an adult is awful.

Which is why there is a vaccine for Shingles on the NHS.

Also, if you never catch chickenpox, you're not at risk of shingles.

I believe the chicken pox vaccine tends to wear off so leaving people susceptible to chicken pox when they are older. CP is generally more dangerous in adults, that’s why I didn’t pursue the vaccine. CP was horrible for a few days but it’s generally mild medically speaking in children.

Agree @TimeIhadaNameChange I had shingles 3 years ago. Absolute worst time of my life ended up in hospital with them it’s was horrible in fact, I would go as far as to say that was worse than my 17hrs of active labour and EMCS tbh when I think about it. If children having mild CP can prevent that as adults for anyone then I’m all for it too!

I looked into this when DS was born, and from what I remember, they don’t know if it’s lifelong protection - so he could then have the vaccine wear off and catch CP as a teen or adult and be far more seriously sick with it.

For that reason we chose against it, however if he doesn’t get chicken pox by the time he’s approaching his teens, we would reconsider.

I also haven’t looked into it for 3 years so everything could have changed! So will follow thread with interest 😊

Everything in public health to a lesser or greater degree comes down to cost-benefit. We don’t have a bottomless money pot, so any intervention at a population level has to be justifiable or there will be less money available for the treatment of other conditions. And I don’t mean just financially justifiable, but the evidence for that intervention has to show a clear benefit, and we’re not there yet for the chicken pox vaccine.

Shingles is more deadly than chicken pox. It’s about whether you think saving a handful of children from death by chicken pox is worth more than a few hundred pensioners dying a painful shingles death.

Is a child life worth more than an old age pensioners life? If so, how much more?

The reason they talk about “cost effective” to NHS is that you’d be trading a few child ICU patients for more pensioner ICU patients.

The other countries when they did their calculations, they did it on economic contribution basis. A pensioner isn’t employed. They’ve paid almost all the taxes they are going to pay. So their continued life is worth less to the economy than that of a child who has a whole life of working and paying taxes still to come. In addition, they added to the calculation for doing the CP vaccine, the cost to the economy of a working parent taking time off work to care for a sick child.

Totally agree op. Every other developed country vaccinates against chicken pox. Chicken pox is usually a minor illness but kills about 50 people every year in the uk and can also cause strokes and other long term disability.

It absolutely should be part of our vaccine regimen but I think poor management of NHS plus lack of money mean it’s not.

The shingles think isn’t even an argument. We have a vaccine for shingles and it would be appalling to suggest subjecting children to a painful abs even potentially fatal illness to boost pensioners immunity to another disease which they easily can be vaccinated for.