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 know Superdrug do both testing and immunisation, just wasn’t sure if one private provider would be better than
another.

I disagree. If @TIGGRx is intending to get her child separate MMR and varicella vaccines, she is not antivax, she is taking a precaution she feels is necessary to avoid them being temporarily unwell as a result of the vaccine itself. It's a reasonable decision, even if you would not make it.

They didn’t because there was a concern that the vaccine could mean less CP in the community would lead to more CP in adults and an increase in shingles. It was essentially exposing chicken to CP to protect adults as that was the least worst option.

Its been introduced now that it’s been shown in the places who’ve had the vaccine for decades that neither of those things happen, and in actual fact the shingles risk will very likely be lessened long term.

Yes, but for anyone even slightly keeping up with the current research, which one would expect to be the case for an infectious disease clinical researcher, it makes no sense.

@mindutopia said:

My dc did not get the chickenpox vaccine. I’m not convinced by the data I’ve seen that it offers lifelong immunity. I was willing to take the very small risk of a serious infection as a child over the much greater risk of serious complications as an adult, especially for women of reproductive age. I’m comfortable with that decision.

I mean, surely most infection disease clinical researchers understand the concept of a booster? if a layperson could understand that the first cohorts to receive the vaccine will be tracked for waning immunity and given a booster if necessary, you would think someone in her position would. And if a layperson can understand the importance of a lowered risk of shingles, you would think, again, that someone in her position would.

I vaccinated my children against it years ago. I can’t imagine inflicting an illness that is at best uncomfortable on them if there’s a simple, safe alternative.
I trust them to be sensible adults and will hand over their health information to them when they are adults including telling to take advice on vaccine boosters. It will be their responsibility to look after their own health at that point. If there is any evidence of waning immunity from that vaccine (there isn’t yet) I’m happy to pay privately for a titre test at that stage to see if they still have immunity. I did my own for hepatitis at some point before travelling to India and the titre test was half the price of the vaccination.

I will just say that having had shingles on my face as an adult, I would absolutely vaccinate my children to avoid the possibility of that - it's incredibly debilitating and painful and indeed many people never fully recover from the nerve damage. I still cannot properly feel my face in that area more than 2 years on, it has affected the symmetry, and there are people with serious ongoing pain after decades. You can also lose your sight when it gets into your optical nerve. That is only possible if you have contracted chickenpox. My son was slightly too late for the jab and had already had it, but seriously, shingles can be a horrifying, Victorian disease, take the vaccine and avoid it if you can.

The thing about chicken pox and children, is that Sod’s Law says they are bound to get it just before you’re due to go on holiday, or before some major occasion like a family wedding.
For that reason alone IMO it’s well worth getting them vaccinated.

It was decades ago now, we were living in the Middle East, where both my dds managed to get chicken pox (before vaccines were available) and get it over with before they and I were due to return to the U.K. for 2 months, (summer temps there were often over 50 deg.).
However a (Brit) friend was not so lucky. One of her two dcs came out with the first chicken pox spot the very day when they were due on a night flight back to the U.K. for the summer.

She made sure he was completely covered up before flying back anyway. She lived a long way from Heathrow and ended up paying a fortune for a cab to drive her the 150 miles home - she certainly wasn’t going to take him on the train.

I had the vaccine at 18 because I hadn't had it yet and was going into teaching at uni so would have been around young children. We live in the UK now and I felt like since I had the benefit of not having it, I should extend the same to my son. Paid privately at boots years ago and am so glad we did. He's a bit of a nervous picker and it would have been horrible.

That is the reasoning behind some countries opting for not introducing the vaccine to the general public. Turns up the data does not favour that reasoning, but vaccinated countries do have less shingles and children with lesser symptoms when they get chickenpox. UK is changing its path here, because the data is reliable now. I think.

This is my understanding of the advantages:

• A vaccinated child has a much, much lower risk of getting shingles than a child who just caught chickenpox naturally (i believe 1 in 4 adults get shingles in the UK and it can be pretty nasty/have lifelong consequences)
• Whilst most kids getting chickenpox are fine - there is a small but not insignificant risk of very nasty complications from natural chickenpox (bacterial infections of sores, varicella pneumonia, brain swelling, etc) whilst breakthrough infections if you have the vaccine are almost invariably extremely mild
• Preventing your children going through an unpleasant experience which risks things like permanent scarring from the spots

As i understand it - most other developed countries already vaccinate their kids for chickenpox. We didn't as there was a public health argument that the benefits for the kids were outweighed by the risk of increasing shingles for old unvaccinated people i.e. the concern was never that as an individual it was better to unvaccinated, the view was that on a personal basis vaccination was always better - BUT on a population basis it was a concern that vaccinating some people might reduce the residual exposure of unvaccinated people and thus increase their likelihood of shingles in old age. New modelling has suggested otherwise on a population basis as well.

I had cp as a child aged 7 and then again as an adult!
Natural immunity isn’t guaranteed either way

Thanks @Moopp . I hope you you manage to come to decision on what to do!

And @JustAnotherWhinger @sexnotgenders
I don’t want to steer away from the thread as OP’s kids are older and don’t qualify for MMRV. Personally, until the vaccine rollout, I wouldn’t have considered CP vaccine for my children. I just didn’t view it as being different to hand food and mouth, etc.

Theres numerous peer reviewed publications have highlighted an increase in febrile seizures with MMRV.
So here’s a few…
https://pubmed.ncbi.nlm.nih.gov/20587679/

https://pmc.ncbi.nlm.nih.gov/articles/PMC4119141/

https://www.sciencedirect.com/science/article/abs/pii/S0264410X13017428?via%3Dihub

Just so you know I’m not pulling it from my behind or spreading anti vax misinformation!

I remember some years ago, the man next door (in his thirties) got shingles and it was very close to his eye, so was a great concern. It was over the Christmas period and he had plans to spend it with his parents, but obviously had to cancel. I fed him during that time by passing food over the fence, so at least he could have the Christmas meals, albeit on his own.