To ask for opinions on varicella vaccine vs natural immunity?

[Moopp]

I am not an anti vaxxer - me and my kids have had every vaccine offered so far. My kids will be eligible for a single dose of vaccine in the next year on the NHS. They have not yet had chickenpox, as there's only been one outbreak locally and we missed it.

The varicella vaccine offers protection for 10-20 years, and many people may get lifelong immunity, but it's only been in use since the 90s so it's presumably actually an unknown.
Natural infection generally offers lifelong protection.

My options:

• try to get the kids infected naturally before their vaccine appointment comes through. Very low risk of serious complications as they are both healthy, age 3 and nearly 5. They get lifelong protection.

• get them a single dose of vaccine, which offers 95% protection for 10-20 years (maybe more). They might then contract chickenpox in adulthood and it is much nastier for adults.

I will not leave them both unvaccinated AND uninfected, as I want to contribute to herd immunity. That's not an option.

Obviously eventually we might as a country get to a point where so many people being vaccinated means there is so little chickenpox circulating that their chances of catching it as older adults is really small. But that relies on vaccine uptake (or natural immunity) being above 80% I believe, and I'm not sure I have that much faith in people's decision to choose to vaccinate anymore. It will be generally offered with MMR, and uptake for that is currently 84% and declining.

It's worth mentioning that both my kids are boys, so I don't have to worry about the additional risk of them getting chickenpox in pregnancy should their vaccine based immunity wear off in less than 40 years.

If anyone is really knowledgeable about long-term varicella vaccine immunity I'd really value your input. Also I'm just interested if anyone has a perspective I haven't thought of.

I was the exact same, had it 4 months ago and haven’t felt right since!

Yes, but my kids are 3 and nearly 5, so it will be a standalone catch-up vaccine for them, and only one dose rather than two, so not as effective.

I thought that they were planning to give those children a second one in due course.

Get the vaccine. I was told to vaccinate my child before we went to NZ as if they’d got it there, it would be worse for them as all the others had been vaccinated. This came from a professor in immunology but I haven’t researched the science.

In any case, it can be really awful so best to just vaccinate

It's totally worth it just for the peace of mind! The problem with expecting them to get natural immunity is that you never know when it'll happen and it's always going to be some time that's hugely inconvenient (just before a holiday, over Christmas, as soon as you have an urgent work deadline). You have to spend days worrying about it, and they might not even catch it at all which just postpones the stress again.

DD's been through at least 3 waves of chicken pox at nursery and school. Loads of kids getting sick each time, missing 2 weeks of school etc. Since getting her vaxxed, it's literally not even a topic on our mind at all and it feels great.

Also, if you are very unlucky then they might not catch it at all! I somehow managed to avoid it as a child and my parents simply assumed I had it at some point since I did have a few rash-y things. Ended up catching it as a teenager and it was horrendous, still have the scars from it. Another school mum I know also never had it and caught it off her own daughter.

Interesting! I read that they had decided that as children that age had probably already been exposed to CP that one dose was fine (ie more cost effective). Unfortunately for me, my kids have definitely not been exposed.

I am in Scotland so I suppose it's possible it's different to rUK.

I had both my kids vaccinated privately, they both had 2 doses. I believe there is the option for a booster dose in later years should you be concerned about waning immunity.
I had CP when I was 8, I remember how horribly ill I was, then I got shingles in my 30s. Both bloody awful, and I was sent home from work as soon as I was diagnosed with shingles as a girl on my team was pregnant at the time.
If you have the option to vaccinate at the same time as MMR I would definitely do it!

I'd get the vaccine - CP causes scarring, risk of encephalitis and infected spots as well. It wasn't available when DS was a small child.

Poor DH got shingles when DS was born and couldn't attend the birth or see DS for a while afterwards. Really painful blistering on his jaw and face too.

A few things: 1) chickenpox is a serious virus with many potential complications, even as basic as scarring. My kids both caught it before the vaccine was offered and now have scars (including on their faces). 2) you mention multiple times that the vaccine does not offer lifelong immunity. Neither does the virus! I know multiple people who have had it more than once. The vaccine is a live vaccine designed to mimic infection, and so protection will be similar. 3) FWIW, the vaccine is offered combined with the MMR, and as a result the vaccine schedule has changed. I’m not sure how declining the CP vaccine would impact all the others. My kids both recently had the vaccine even though they have had chickenpox.

please get your children vaccinated.

and if it’s relevant, I am also not an epidemiologist, but I am an immunologist ;)

As someone who's had shingles, I'd get the vaccine without hesitation. There's a theoretical possibility of getting shingles secondary to the vaccine, but it's extremely rare compared with getting it secondary to the wild infection. If you can spare your kids that in later life, why wouldn't you.

I've no idea on the science of it but I daresay there will be studies as it's been used in the US for decades, the original babies getting it will be roughly childbearing age now. I have to say I suspect that the idea the vaccine protection wears off is a bit of a myth. If it was a problem that it wears off, then booster doses would be recommended but they aren't, which makes me think either it doesn't wear off, or if it does wear off then it doesn't cause an issue. There are other vaccines that we get in pregnancy to protect the unborn baby, and I remember having my immunity to mumps checked when I was pregnant with DS1.

I will only say that I moved to Germany 13 years ago and I've literally never in all that time heard of a single case of chicken pox, not among my friends' children, not at nursery (and they get every other bug), not at school, not among the elderly ladies at choir - and one of them had measles last year and was very unwell with it. The only times I hear of it are from friends in the UK with small DC or on mumsnet, and it's often jarring because I've basically forgotten it exists, it looks awful - seems mad that we consider(ed) that normal.

DS1 who was 5 when we moved here had a catch up jab as a teenager as he'd never caught it.

The main long term thing I was glad about with my DC having the jab is that they don't have the 1:4 chance of developing shingles that everyone who has been infected with the chicken pox virus has. I've not had shingles (touch wood because I've had chicken pox) but a colleague had repeated bouts in his 20s and it sounded absolutely miserable.

I didn’t realise it protected against shingles. I’ve had shingles three times, is it too late for me to get the vaccine?!!

Australia introduced the vaccine in 2005 so they must have lots of data. Here's one lengthy report if you have time on your hands!
My vote would be for the vaccine. Too late for my DC, one of whom has facial scars from the horrible spots.

pmc.ncbi.nlm.nih.gov/articles/PMC9507199/

No, the jab doesn't protect against shingles. You need a shingles jab for that.

I mean if you have had chicken pox then you're automatically high risk for developing shingles. No chicken pox, no high shingles risk.

If you've had shingles, then you've already had chicken pox. So yes, it's too late for the chicken pox vaccine to protect you against dormant varicella.

I had chicken pox as a child and was quite poorly. Now as an adult I'm terrified of getting shingles, everyone I know who has had shingles has been very poorly.

I paid for it for my second child.
First child had it so severely. And had shingles age 11

Get the vaccine, it's a no brainer. After chickenpox, the varicella-zoster virus stays dormant in the body for life. It can reactivate later as shingles which is extremely painful and studies now show increases the risk of dementia down the line.

@BertieBotts A friend of mine from overseas was genuinely horrified when I explained that chickenpox is just rife in children over here! It’s been eliminated there for a long time.

I paid privately for my two, without hesitation. Aside from the potentially nasty complications, the fact it’s an horrible thing to actually have, and time off school/activiries, it can cause facial scarring and if I can avoid that for my child then I will do so. One of DD1’s friends has a large pockmark very obviously on her face from a normal bout of CP.

Obviously completely your call. But, My youngest of three didn’t catch CP at nursery and we said by the end of Reception if he didn’t get it we’d vaccinate. Then we put it off and he got CP in yr 1 and ended up quite poorly with some infected pox and needed antibiotics. Meanwhile my youngest two had it in nursery and sailed through. I’d say give yourself a deadline and book it. If I could do it again I’d get him the vaccine. I had a feeling he’d struggle with the pox but I didn’t pay it enough attention.

Dementia too? Oh great!

I paid for DD to have 2 doses of the varicella vaccine privately when she was three.

in your shoes I would take the vaccine dose then if you are worried, pay for a second dose privately.

As the MMRV is being introduced as a default childhood vaccine, the idea will be that once it beds in, the amount of circulating virus in the population will lower dramatically: this will then change the likelihood of your children (and all of us) encountering the virus in future in the wild.

With chickenpox, the “natural virus vs vax” equation isn’t only about serious side effects or the unpleasantness of having the acute virus — but it can also leave permanent scarring. I had it as a child and it was relatively mild: my sister got a nasty dose and still has facial scarring from it that will be lifelong. You can always get a booster for your kids when they are older if you are worried about waning immunity. Scarring can be permanent.

They can do a blood test for chicken pox immunity. You talk as if you only get 1 shot at the vaccine. If your immunity drops off you get a booster. It’s not a big deal. You are talking like catching chicken pox is better somehow? In my opinion, if the vaccine doesn’t stick and your immunity wears off after 20 years it’s likely that immunity from catching it could wear off too in that person.

Yes all my kids got the vaccine about 2 as part of the immunisation schedule. I had chicken pox as a child and had it quite mildly. My sister had it really badly. Definitely not something I would risk.

and like others have said too cuts the risk of shingles. It will be interesting to see in 20 years if the shingles rate goes down here. We offer the shingles vaccine to people over 60 currently.