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 had the vaccination in my 40s as hadn’t had CP as a child. DS has been vaccinated too aged 18m or so.
horrible disease - it can blind you if spots go into your eyes. I’ve no idea why people wouldn’t vaccinate their children from it - especially now it will be available on the NHS. It’s also not that costly privately either.

Here's the JCVI advice recommending the varicella programme, with various references: https://www.gov.uk/government/publications/childhood-varicella-vaccination-programme-jcvi-advice-14-november-2023/jcvi-statement-on-a-childhood-varicella-chickenpox-vaccination-programme

I would think that they thought about the overall benefit in terms of years of immunity granted by the vaccine, what happens to adults, the impact of the natural experiment we've already had where unvaccinated people get "natural" Immunity through catching varicella etc etc...I'm not sure why you are trying to replicate the decades of expert experience that the JCVI members have, and trying to second guess things you think they might not have considered, when I assume you don't have anywhere near the academic training. How can amateur reading-up get anywhere near the scientific rigour that that committee has?

There are 19 core members of JCVI, so I'm pretty certain they will have already discussed all possible pros and cons of introducing this vaccine and the impact on individuals...www.gov.uk/government/groups/joint-committee-on-vaccination-and-immunisation

What made you decide against getting the vaccine in childhood and then getting a booster vaccine in early adulthood?

My understanding is that you can only contract shingles if you'd had chickenpox. The virus remains in your body to re-emerge as shingles.

My middle child had chickenpox as a 5 month old baby. He was really poorly and I was determined to get my youngest vaccinated. He contracted it before I had the chance but, thankfully, it was quite mild.

I would imagine with the vaccine that there will be boosters available, particularly for women. I'd definitely not be attending any chickenpox parties.

I always meant to vaccinate my eldest and then she caught chicken pox. What a miserable week that was for her, I was terrified her skin would scar as she had some huge spots.

I wish I could have prevented that by getting her vaccinated and I didn’t hesitate to get my second child vaccinated, even though it was quite expensive.

If you have the opportunity to get your child vaccinated, I personally world. Why would you inflict an illness on a child when we have something to prevent them being poorly, avoid scarring and the
(admittedly very small) chance of serious complications.

I’ll be keeping an eye on long term immunity, I believe they’ll introduce a booster in the future if needed.

Just get them a booster if you're concerned about waning immunity! DH had the vax at the same time as DD as he'd never had it. I had a catch up MMR after an immunity test showed I wasn't immune to rubella (I think I was one of the early cohorts for MMR and only got one dose, though I've since heard a few stories of repeated vaccination with no immunity, back in the day when the NHS used to routinely screen for it).

It might seem a bit silly for those who survived to adulthood without dying or suffering serious consequences from something which is now completely unnecessary. This is survivor bias - those who did die aren’t here to tell their tale. A bit like when my grandparents thought it was daft that my parents insisted on baby car seats. They’d had lots of kid who were all just fine in a Moses basket and normal seat belt.

I would go for the vaccine personally, but that's based on my first child being off school for about 2 weeks with it, and my DD2 hospitalised with it aged 3 due to sepsis from an infected pox spot (and very healthy normally).
I think the chances of catching it again in adulthood would be slim, and if someone has been vaccinated previously then in theory they probably would get a milder case than if they hadn't been vaccinated or naturally infected as a child at all?

I paid for all of my children to have the vaccine privately a few years ago. When my daughter becomes 18 I'll ask her to do an immunity test to make sure she's still immune - if not, I'll recommend a booster.

The vaccine has only been a thing on the NHS for about a month. One of my GC has it on the first day it was given Apparently due to ages staggering should've been later but they were having the rest don'e so nurse agreed to do it at same time

I want to say as the parent of two children (out of three) who have had febrile convulsions, if a child is predisposed to them, they will very likely have them with any number of routine childhood illnesses that come with a sudden high fever. Both of mine had them with sixth disease (roseola), and they are more likely to have an episode with actual chicken pox than with a vaccine. It's also worth pointing out that while febrile seizures are very alarming for the parents, they don't cause lasting harm.

@Moopp
Since the first large cohort of children to have had varicella vaccines in the US are now in their early thirties, you will know if a booster is necessary long before your DCs reach the age where that might be an issue.

Get the vaccine. It will have been created based on a lot of statistical data demonstrating that it will have a benefit. If it wasn't beneficial or cost effective, it would not be on the NHS.

Really? You're an infectious disease clinical researcher who is more comfortable with allowing your child to have an illness that could result in the misery and danger of shingles than a vaccine that might require a booster?

My husband and his brother were seriously ill with CP as children. It triggered a rare autoimmune issue that caused both of them to develop type 1 diabetes. We had our child vaccinated for chicken pox privately.

My son was so ill with chicken pox, had them all in his mouth and around his genitals. Couldn't eat for two weeks and lost loads of weight as he was only three.

I've had my middle child privately vaccinated and my baby will have the NHS pathway vaccine

I had an amazingly easy time with chicken pox age 5. My mother took me to a nurse to confirm the diagnosis, because it was that mild.

I had a rather less easy time of it when I caught it again, age 30.

Just sayin'.

My child was very ill with CP. Well over a decade later over 100 scars are still visible. Now that a chickenpox vaccine is available I would urge everyone to vaccinate their child.

My 5 year old was so poorly with chicken pox if I’d known about the vaccine I would have got him the protection. It was awful.

Don’t expose your children to chicken pox knowingly. It opens them up to getting shingles later in life, which is horrific for some people and the issues associated with it can last months and even years. Get them vaccinated. I had chicken pox as an adult, it was awful. Three weeks off work!

I had both my DDs vaccinated privately (eldest now a late teen). Both held through multiple waves of CP in classmates over the years.

I’ll advise them to get checked for immunity in their 20s / pre having children and they can get a booster then if needed.

This, you can’t get shingles if you haven’t had the chicken pox. But if you’re vaccinated for chicken pox, you won’t get shingles. Shingles is horrible and has long term effects for a lot of people.

The fact the vaccine lowers (in some cases will nullify) the risk of shingles is a reason in and of itself to have it.

whilst in many cases CO is mild that’s not always the case, and shingles is hideous.

It wouldn’t have been added to the standard vaccinations if it wasn’t worth it.

They won’t tell you that because it’s simply not the case.

My son has some lifelong scars from chicken pox. Ok, I understand that they don't threaten his life but I do wish I had paid for the vaccination. I naively assumed that he might get it and come out fine

It’s a standard vaccine in Australia. When we arrived all my kids had already had chickenpox (and were too old to get the vaccine at the usual time anyway) so their medical records show them as having “incomplete vaccinations” which really annoys me! Like a PP I have never met a kid here with chickenpox.