have you given your child the chicken pox vaccine

[passivehoovering]

Hi all,

DD is 3.5 and is about to start her second year at nursery. She hasn't had chicken pox, and I really don't want her to. I don't want my darling child to get ill, feel bed, get scars, have awful complications, be seperated from her friends...So I was thinking about getting the Chicken pox vacine for her. I have mooted this with friends who also have children but they seem to want their kids to get chicken pox so I am wavering a bit.

If you have vacinated your children could you tell me how you went about it and where you found info? I don't know if I should try her GP in the first instance and ask them for info from Medline and if they know of anywhere that does the vacine. Also how was your child after? Anything else you can tell me would be much appreciated too.

Thanks

We cross-posted Elaine. Your one-liner was much better than my two paragraphs!

I do agree to a certain extent that people doing their own research is a bad thing too but I don't think you will stop it.

We can look up research papers that are outside our field of understanding, if we are honest, and draw all sorts of wrong conclusions. I suppose we are less likely to be taken of a ride which is good but as you say, you also need to know or be aware of what you don't know. I have an understanding of how research works from a largely unrelated field to this one (psychology) so I hope I am careful about what I link to because I know that there is probably research out that that comes to very different conclusions and we don't know, not being experts in the field, what is really the most accurate. However, I would rather try and research issues than accept what I am told as I would have to have done 30 or 40+ years ago. Knowing the information is available, I can't not look at it. I suppose Pandora's Box has been opened!

Elaine - The other side to the coin of seeing stories of children who suffered from a serious form of the illness is that you also see more stories about those who have suffered due to the vaccine. Look at the MMR issue - the Internet was flooded with people who believed they were affected by the vaccine even though some of them probably weren't (trying to be careful what I say here, don't want to offend). You only have to look at the threads on here to see how it would be possible for these stories to have the entirely opposite effect on vaccine uptakes to the increase you would expect.You would hope that most people know that what you see on the internet is a skewed view of the reality where the majority are either not that bothered about a vaccine since CP is, for most, a mild disease or conversely had the vaccine but had no side effects for their health or those close to them but perhaps past experience doesn't bear that out.

The upshot is that I don't think you can really predict the effect of people's own research on vaccine uptake. It could go either way.

LeBFG - you were saying you would rather people relied on the opinion of Paul Offit or experts, than spend hours on the internet but I had never heard of him before this thread. How do I know that he isn't another Andrew Wakefield without doing a load of research, ie somebody who appears to have all the answers but ends up being wrong. How do you know who to trust? For example, it strikes me that he is a paediatrician so well qualified to talk about CP in children and the implications of the vaccine on their health but he isn't an expert in geriatrics and therefore perhaps not the best person to comment on the impact of the vaccine on shingles and the elderly. When faced with this kind of dilemma how can you really stop people checking things out? Trust in experts has been eroded. I suppose we have Wakefield to thank for that.

BBB

My point is that there seems to be an over emphasis on personal anecdotes in anti vac people's decision making process. Unfortunately, deaths averted doesn't make for an anecdote. If vaccination rates fall and preventable diseases return (as they will), there will be many stories of children who are illness damaged (with a clear causal correlation as well!).

Paul offit is head of infectious diseases at the children's hospital of Philadelphia. He's also a co-inventor of the rotavirus vaccine.

I can't think any one person can have all the answers, and even with the best of information, can still be wrong. This reminds me a lot of weaning age a few years ago. The WHO had got in all the experts in all the appropriate fields and based on the ensuing debate published the 2000 guidelines stipulating that parents ought to wait to 6 months to avoid allergies. Subsequent research accumulated to show that avoiding earlier exposure to allergens may lead to allergies. It may be the case that the WHO's 2000 guidelines were wrong, but done so with the best of intentions, so to speak. All 'truths' can change in the light of new research. So called 'experts' can definately get it totally wrong, so I think, if you have that sort of inquiring mind, be questioning. But finally, accepting at times too. We all have to make decisions, for better or worse - we can't know all things. Choosing not to vaccinate (despite what one may feel) is still a decision that is taken and which has consequences.

I supppose you look at 'expert' credentials too - there's this bloke who's made a packet out of selling single jabs in the wake of Wakefield hysteria and now publishes books to further extend the hype - I would rate his credentials poorly as the guy has a serious conflict of interest! After following these threads, I also now do a quite check of current research but then quickly find a few review papers or a meta-study, that kind of thing, which are probably able to say a bit more than the odd paper here and there.

Elaine - it would depend on your view surely. You see an over emphasis on ancedotes from the anti vac people, but somebody with the opposing view might see something entirely different.

I googled Paul Offit. I know who he is and what he does but, having just read about him how am I supposed to know if any of that stacks up or the nitty gritty of what his peers think of him without really looking into it. And as I say, in this case he is an expert in child vaccine but that doesn't help with a discussion on shingles in the elderly really does it. I would have to defer to another expert on that one.

LeBFG - we know enough about research to know where to look and what to look at and have an idea of what makes a reliable source and what doesn't but I would say that makes us the minority. If I am honest, if it is a field which I have less understanding in, it makes me less likely to rely what I find not more. I know how it can all change overnight with a new piece of research. Unfortunately, credentials are all very well but if you have somebody like Wakefield coming up with a piece of research that upset so many people, all the credentials in the world don't mean anything.

I sound like a massive cynic now I suppose but knowing that a little knowledge is a dangerous thing I tread warily. You never know what massive skeleton is hiding in the closet waiting to come out and bite you. If Wakefield's research had been right and had his motives and methodology had been top notch, for example, that would have had massive reprecussions. As you say with the weaning advice, there was another massive shift in thinking that left confusion and misunderstanding in its wake. (I followed that advice despite the shift happening between the birthds of my two but only after really looking into it - I not of a completely closed mind)

For me the shingles thing is a massive stumbling block. I don't need to decide about vaccination. My two have had CP but this debate is still important to me because I don't want any decision to vaccinate to effect my children adversely. I am glad if you vaccinate and your children don't get CP but you may have left my children wide open to shingles and I am not very keen on that.

Paul Offit's standing among his colleagues is the exact polar opposite of Andrew Wakefield's. Offit is universally very highly respected.

EB, you're still missing my point but things have moved on. I'm sure we'll come back to it on another thread.

The thing is, BBB, you shouldn't approach the question having made up your mind, you need an open mind!

If you believe in the scientific approach, then anecdotes are at the bottom of the evidence table. THey shouldn't be ignored but used for hypothesis generation or a better understanding of the statistical findings. But in and of themselves they provide little evidence of anything. This is regardless of whether it is an anecdote about vaccine damage or an anecdote about vaccine safety.

And you're missing my point BM.

That the process by which elderly have less protection from shingles through reduced exposure to the CP virus when children are vaccinated is the exact same process through which non-immune people are less likely to have CP through reduced exposure to the CP virus.

Your contention that herd immunity cannot exist in a vaccinated population means that you can't then claim that shingles will be affected by vaccinating children. [for the record, herd immunity in vaccinated populations does exist and this is the reason why shingles will probably increase if we vaccinate against cp wihtout a shingles vaccine]/

No, I understand what you are saying. You clearly just didn't get the point I was making. Oh well! :)

We can discuss the herd immunity issue on another thread another time. You're making some sweeping generalisations about 'my beliefs' and 'contentions' and I don't really have the time (or inclination!) to get into a lengthy discussion about it. Too many things going on in RL at the moment. Tab made a few good points earlier.

How about a new thread for herd immunity? I'll start one as it's a subject that interests me. Particularly after a health visitor I saw told me it was a reason why I need to vaccinate my child (nothing against her as I happen to really like her).

In what way had I made up my mind Elaine? I started off at the beginning of this thread open minded about CP vaccination but just expressing the concern that maybe we have enough vaccinations already and that perhaps this one wasn't the most necessary if we were thinking of adding more to the schedule. I specifically said that I didn't know much about it but over the course of the last few days I have done a lot of reading so I am a little better informed. It has taken most of the thread for me to come to conclusion that I would really rather see a shingles vaccine that CP. If you are vaccinating to save people from really suffering from a disease, there is really no doubt in my head that shingles is way ahead of CP in having a case for vaccination. That was after looking at a lot of evidence, most of hasn't been posted on this thread, admittedly but there is nothing more boring than a thread that is just a set of links.

As for ancedotes, you seemed to be saying that only those who are anti-vac are using ancedotes. I know that anecdotes aren't the best sort of evidence (although their usefulness is entirely dependent on the way the anecdotes are collected I would argue but we won't get into the whole methodology thing because that really isn't the point) but I was pointing out that anedotes go both ways - all the stories of people had CP really badly for example even though they are a small minority of the total number of cases - but you seem to not want to acknowledge those anecdotes as being worthless as well. You can't pick and chose your anecdotes to suit your argument.

LeBFG - can we have a link to your thread if you do one please?

Whoops sorry, not LeBFG - Tabitha.

With pleasure.

www.mumsnet.com/Talk/vaccinations/1560173-Herd-Immunity

The you was a generalised one, rather than a specific one BBB. Sorry for the ambiguity.

Anecdotes about cp being severe simply illustrate the statistics - that it can be severe for a significant minority. There is also no doubt of the causal relationship - that the chicken pox virus causing chickenpox which is the cause of any secondary complications. The statistics and causality are what should drive decision making, not the anecdotes, interesting and enlightening as they may be. This is not the case with the vaccine 'damage' argument.

All I'm saying is that the anti vac arguments rely heavily on anecdotes with unsubstantiated causal relationships and no statistical evidence at all (plus conspiracy theory and false idols - with a bit of genuine scientifc theoretical speculation thrown in for good measure).

I think scientifc qualitative research is hugely important and relevant. Making decisions based on people's stories on the Internet impresses me less.

The anti vac arguments don't just rely on ancedotes though do they? Did you not read the link I posted a few days ago on a paper by Gary Goldman who look at the way CP affects shingles in the US? The guy worked for the surveillance team monitoring the CP vaccine and its effectiveness - a project funded by the CDC before he left so clearly isn't against the CP vaccine. He was the one who reported that shingles case are up and that any decline in the CP would be offset in an increase in the number of deaths from shingles.

Maybe not so much an antivac argument admittedly more a 'don't put the cart before the horse' argument or maybe 'an antivac for now until we have sorted out shingles' argument . It make sense that shingles should take priority over the CP. Everybody who gets shingles suffers. It is horrible. Most children who get CP do not suffer a great deal if at all. The only advanatage to giving the vaccine to children is that the uptake will be greater but at what cost? There is nothing wrong with the CP vaccine and the effects it has on the children who receive it, but there is plenty wrong with its wider effect on the rest of the community

Before charging in with a CP programme in this country perhaps we should be looking at the American experience and learning from it not repeating what they did and wondering why we have a lot of sick old people in a few years time. Maybe we wouldn't have the same profile of disease as the Americans have but it needs looking at before we start routinely vaccinating all children against CP.

I'm not 'anti-vax' (obviously!) but I also don't have a problem saying that it is likely that vaccinating against CP will increase shingles amongst the elderly. That's waht the scienfitic evidence shows. It is also quite right that the NHS look at this issue from the population level and roll out a shingles vaccine ASAP prior to a CP one.

I haven't actually heard one person say that they haven't vaccinated their kids against cp because they're concerned about shingles in the elderly!

Vaccinating against CP will not only stop my own children getting CP but also significantly decrease their likelihood of getting shingles. To paraphrase bumbleymummy, adults should take responsibility for themselves and not expect children to take risks for them. Whilst I'm sorry if vaccinating my children against CP raises others' risk of shingles (including my own) but my primary responsibility is to my children and since there is a vaccine against shingles available, I expect adults to take responsibility for their own health and not rely on children.

My concern is that the information isn't being put out there. You have the parents who have heard for the CP vaccine and want their children to have it just because they have it America without knowing the wider implications. Who is out there pushing for the shingles vaccine? My mother hadn't heard of it despite being of the age to have it and being clued up on health issues. She has also had shingles. She wouldn't want it again, I can tell you.

You also forget that younger children who haven't had CP they are in the minority. There are a lot of children who have had chickepox who are now also at risk of getting shingles. What are their parents being told about the potential to have the shingles vaccine? Nothing and it is a very long time until they are 70. There is a likelihood that the age at which people are getting shingles will lower if more people get vaccinated so there could well be an epidemic of shingles in younger people who nobody is currently thinking about.

What it boils down to is that you want to push a programme for the minority which could adversely affect the majority. As you say, we all want what is best for our children, so as far as my children are concerned, I don't think the NHS should be paying for such a short sighted course of action which is not doing them or the majority of the current population any favours. Look properly at what has happened in America and then decide on a course of action but until that happens, it seem very sensible and reasonable to continue the way things are and if parents want to pay for the vaccine they can. Thankfully, the vaccine doesn't look like becoming part of the standard vaccinations any time soon so we are saved that worry.

Well, with all due respect, at the individual level, I'm very very glad my vaccinated children are far less likely to get shingles (which is what it looks like so far as vaccinated cohorts age) as well as not getting chicken pox. And they've actually benefited from both worlds - being vaccinated children in an unvaccinated population (although now we're in the US, they've lost that additional benefit).

I haven't seen an 'epidemic' of shingles among young people here and also the vaccine is recommended from age 60. Also the severity and duration of shingles increase with age. There is SOME increase in incidence in shingles when you vaccinate against CP but shingles is scarily common even when children are unvaccinated.

Personally I think it's very inequitable in the UK that if you can afford the vaccine, your children can avoid shingles later as well as CP. But I can understand that they want to roll it out following the shingles vax roll out. I just wish they'd get on with it and offer it also to people from 60. I'd be mightily pissed off if I were a 60 year old in the UK being denied the shingles vax.

Seems unfair that the health choices are only open to those who can afford it.

The long term disease dynamics of a new vaccine is always going to be, to some extent, unknown. How could Alexander Flemming have predicted the problems with antibiotic resistance? How can we know is we vaccinate against shingles, some other problem will arise? In general (and I know very little of the field, so correct me if I'm wrong) public health initiatives are done with a great degree of circumspection. So the various known costs and benefits discussed and weighed up and where there is a clear public health advantage normally this route is taken.

We can look at the States and be cautious. And in 50 years time curse the UK decision makers for not taking an obvious step to protect public health.....or we could be patting ourselves on the back that we didn't do what the States did.

Am coming into this discussion very late, but would like to share my experience for what it's worth.

I wanted to get my two DDs (aged 4 and 1.5) vaccinated this spring, as my husband has been working overseas and I also work, and was worried about how on earth I could organise childcare for 4 weeks if they contracted CP one after another. However, our doctor here (Belgium) talked me out of it, and stressed that it was a very mild disease, and only children with weakened immune systems are at any risk.

Of course they did contract it while my husband was away. Elder DD caught it first, and she developed serious swelling in the face, caused by a Group A strep infection which resulted in her going into toxic shock and being hospitalised for 2 weeks. Our GP did not recognise that her symptoms were serious and sent us home with antivirals - it's only because I felt something serious was wrong that I took her to A&E. Fortunately I took her in when I did, as had I waited much longer then the outcome could well have been very different.

IMO, we are constantly told that it is a mild disease, and therefore if a child (especially one that it usually strong and healthy, like my DD) develops complications the alarm bells just don't ring quickly enough for many of us (and many GPs).

My second DD caught CP a couple of weeks after her sister and had a fairly normal bout of it -fever, grumpy, itchy, scabby, and a few scars. Nothing out of the ordinary, but I still wish I had prevented it by getting them both vaccinated.

The infectious disease specialist at the hospital told me that he was strongly in favour of a widespread CP vaccination programme too.

I agree with LeBFG but we know the problems that shingles are causing. We don't have to predict them because they are there to see from the American experience. No we don't know the effect of a shingles vaccine but I think, given what we know about CP that we can have a good guess. There are probably more knowns than unknowns on this one.

gastrognome - I am sorry that your DD was so ill. It sounds really nasty and you would have benefitted from the vaccine but your doctor was not wrong to point out that complications like that are relatively rare.

Of course he should have recognised when her CP got beyond what is expected as normal. On the other hand, doctors are human and if the CP vaccine was introduced, misdiaognosis would probably get more common not less. People (adults mainily) who hadn't received the vaccine would get it worse, mostly because they didn't have the exposure to the naturally occurring virus and there is the potential for them to be misdiagnosed. You fairly frequently see in the paper cases of doctors not recognising measles or whatever because in all their working lives they have never seen a case. It is just something in a text book to them. Those who did get a dose of CP despite the vaccine (it does happen) could also be missed which has the potential to cause local outbreaks.

I know that doesn't lessen your resentment at being talked out of the vaccine or make you feel any better about your DD being so ill but one case is not convincing in and of itself. We have to look at the bigger picture and look at the effect on eveybody of a mass vaccination programme.

I hope your DD is fully recovered now.

I'm not sure of the best way wtr vaccinating against cp or not. I suppose I was trying to make the point that it's hard to make public health descisions. On the one hand, you have access to a very effective vaccine that stops lots of children getting sick and also preventing the rare but nasty side-effects of a disease. On the other, you temporarily make another portion of the population more sick, but then have the option of a second vaccine to prevent this from happening. It isn't straightforward to choose between vaccinating or not.

Bertha I fully agree that my opinion is totally biased given what we experienced.
Had it not happened I doubt I'd be in favour of mass vaccination, and probably would have been glad we didn't bother.

But I am annoyed that many of us are led to believe (by medical professionals) that CP complications are only experienced by children with an otherwise weak immune system. It lulls us into a false sense of security.

BBB

Just so you know, vaccinated individuals who get cp usually have it more mildly and are less contagious.