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.

I completely agree. My youngest caught it at 4 months old. He was really poorly, had to go to hospital. I'm also sick of people saying that babies under 6 months don't catch it because of mum's immunity. They do.

@AlternativePerspective

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.

I agree. And one of the reasons some children suffered badly with chicken pox was because they were given iboprofen to reduce their temperatures (which we now know not to do, but I remember giving it to my son when he had chicken pox, fortunately he was ok).

It's a pity lockdown hasn't killed chicken pox (and headlice, but they'll survive a nuclear holocaust).

So essentially, until it is cost effective, children catching chickenpox is to lessen the effect on adults potentially getting shingles because we also can't afford to vaccinate adults against shingles...??

I paid for my dd to get it at the cost of 230 euro . For me it was worth it. I got chicken pox twice , once as a child which was mild and the second time as an adult . I have honestly never been so sick in my life, I couldn’t get out of bed for two weeks .
Still haven’t gotten toddler dd vaccination but will book her in when things calm down a bit

It’s also completely untrue that the current vaccine for chicken pox (given in two doses) wears off.

More anti vaccer rubbish.

The decision over whether to offer something on the NHS is always difficult and highly emotive, but I think this is the right approach. Without tax rises to properly pay for the NHS, tough decisions and cold cost/benefit analyses need to be done.

I had chickenpox very badly (spots inside my mouth and I was hallucinating with fever) and shingles in my 20s. I can still see a good argument for not offering the vaccine free and as standard.

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.

I know one child who died as a resilient chicken pox and another who was left severely brain damaged

@FTMF30 it can be a deadly disease.

@CayrolBaaaskin That is exactly my view. If shingles is so awful for adults and is a genuine risk if kids don't get chickenpox then a vaccine should be given. Why should children be exposed to, even if it mild, is a horrible illness because it might give adults a boost against shingles.

It is notable that a small minority of people will not build immunity with the vaccine or the virus (which I think is the same for other vaccines).

All spending decisions in the NHS are based on cost effectiveness (I work in infectious diseases). The issue with the chicken pox vaccine (actually it's an issue with a lot of childhood vaccines, more on that in a moment) is that it doesn't offer lifelong immunity. It would probably get people to adulthood (around age 20-30) and then they would need a booster shot (probably several) to continue to have immunity. Getting adults to come in for a jab is really difficult - just look at COVID. Even when there is serious risk to life and health and huge economic implications of a virus, there are plenty of people who are massively resistant to getting vaccinated.

But the specific problem with chicken pox is that it's a much more serious infection in adults usually than in children, and it can also cause pregnancy complications/stillbirth. So it means creating a situation where children are protected, but a large non-immune adult population. The costs here come in that it's much more expensive (and obviously just dangerous) to treat ill adults in hospital or pay for lifelong care for a child who was born with severe disabilities due to pregnancy complications. It's the potential implications of severe illness in adults that make it not cost-effective, not the cost of the jab itself.

It's available in other healthcare systems (like the US) because people pay for it privately, same as here. The government doesn't provide free childhood vaccinations. It's a largely private healthcare system, and people pay for them. There isn't the same cost-effectiveness concerns because the government doesn't pay for healthcare, and doctors and pharmaceutical companies are happy to offer the jabs to whoever wants them because the doctors make money every time someone has an appointment with them and the pharma companies make money for every jab they sell.

I would imagne that at the monent (not covid, generally) it's a cost-benefit analysis that says the UK should not vaccinate against shingles.

It isn't a once only decision, it will be revisited regularly, just like all other vaccines are.

There are issues with adult vaccines, as in many adults just don't bother. Who knows they have an up to date tetanus? Nobody! Unless they work in an area where it is usual. And that means you don't have up to date diptheria and pertussis jabs either!

Sp it is easier, safer overall, to vaccinate children, a captive audience, as it were!

I paid privately but was horrified to see chicken pox circulating in my child’s nursery. It’s totally unnecessary. We should be vaccinating - it’s not a high cost vaccine anymore and has been used safely and effectively for decades.

All treatments on the NHS are subject to cost benefit analysis.
Simply put.. there isnt an endless amount of money. They could be choosing between a drug to cure one person, or one to help alleviate the pain (but not cure) twenty people (bit simplistic, bit general idea)

In private systems the more you pay (or your employer pays) the more treatments available. I had more scans when pregnant in Germany than uK... But DHs employer was paying for them.

But again, children should be exposed to a horrible illness to cover adults who choose not to get themselves a vaccine...? I do totally get what you're saying but not sure why children should suffer because some adults who are against vaccines might decide they don't fancy it. That's on them.

I forgot to add, many childhood vaccines wear off in adulthood. I had to have my MMR again a couple years ago because I needed to have measles immunity for work. The difference is that most infections that we vaccinate children for create serious illness in children, but milder illness in adults. So it doesn't matter if the immunity wears off in adulthood, unless you work in a clinical role or something else higher risk. But chicken pox is the opposite. It causes usually minor illness in children, but more serious illness in adults. This is why lifelong immunity is important. That can be achieved with jabs, but that's only if you can get adults to come in and get vaccinated when their immunity wears off, which is hard to do, as most people don't like getting jabs.

I think you are bu. Chicken pox is unpleasant for children yes, but it offers some protection from shingles later in adult life which is more serious.

@mindutopia - chicken pox vaccine is given in most developing countries as a matter of course. The US CDC state categorically that immunity doesn’t wear off and the vast majority of people who are seriously ill or die in the US from chicken pox are unvaccinated. It’s very rare that a vaccinated adult dies or has serious complications from chicken pox.

yes, offers protection to adults who will not go and get vaccines...that's bullshit tbh.

But yes, i do get that hospital staff don't get to decide who is allowed treatment or not if they got ill so i get it would cause them a problem if adults started coming in with shingles etc.

No sympathy to anti vaxxers though whatsoever.

I had my child vaccinated OP. My child isnt there to suffer chickenpox, possible scarring, infected pox to boost someone elses immunity to shingles. If they want protection from shingles, get a shingles vaccination.

[quote CottonCandy01]**@CayrolBaaaskin* That is exactly my view. If shingles is so awful for adults and is a genuine risk if kids don't get chickenpox then a vaccine should be given. Why should children be exposed to, even if it mild, is a horrible illness because it might* give adults a boost against shingles.[/quote]
Because the point of the NHS has never been to keep us all disease / illness free.

It has always been a cost-benefit analysis based on what benefits society as a whole.

We've seen the same approach all through the last year. Disagree as you will, the focus has been on the NHS because that was the factor most needing protection, financially and more literally!

There are issues with adult vaccines, as in many adults just don't bother. Who knows they have an up to date tetanus? Nobody!

If the NHS sent out, 'you're due a tetanus jab' letter, I bet most adults would get it. They've not even tried to make sure adults are up to date, in my experience. And I bet if I called and said I was due a tetanus jab, the response would be along the lines of, 'And?'

@mindutopia - mumps and rubella cause serious issues for adults. We vaccinate children to stop them circulating. There’s no more immunity from the disease than the vaccine. If what you say was true we would see just as many adults as children getting chicken pox, measles, etc.

We don’t. Please don’t spread anti vaccer theories- they’re so dangerous

I didn’t realise there was a chicken pox vaccine. What age can they have it? Think I’ll pay for it for my dd when she’s old enough.

From 12 months @Racoonworld

@CottonCandy01

But again, children should be exposed to a horrible illness to cover adults who choose not to get themselves a vaccine...? I do totally get what you're saying but not sure why children should suffer because some adults who are against vaccines might decide they don't fancy it. That's on them.

Are all of your vaccinations up to date?

Do you have a shingles vaccine?