Is chickenpox more unpleasant than two injections?

[cngodltlbi]

On average.

Thanks bumbley, I am going to get him
Seen. He's feeding ok during let but then becomes disinterested and cries.

Sorry for hijacking thread!

Hayley definitely take him back. One of the problems with chicken-pox or a young child having any recognised virus is that it can maske the symptoms of something else entirely.

My dd who was seriously ill ended up in hospital turned out to also have an ear infection (why the f no-one had checked in her ears at any other point before the hospital were panicking that not even they could get her temperature down I will never know!). She was absolutely covered in spots, in her eyes, genitals everywhere so it never occured to any of the medics that there was anything else to look for I guess.

She just got steadily more and more unwell rather than improving 3 days and nights without sleep was what made me demand an out of hours doctor

The 85 % coverage is 1 dose not the two. Two doses improve coverage and 100% effective at preventing severe disease.
I have yet to find any evidence of waning immunity in Japan, from what i can gather it is theoretical at best.

and further more for BM who keeps insisting that it is only children with health conditions that get severe CP

""Children up to 12 years of age with varicella disease who are otherwise healthy account for 80% to 85% of varicella-associated physician visits, 85% to 90% of hospitalizations, and nearly 50% of fatal cases.""

Hope your DS is ok Hayley

"I have yet to find any evidence of waning immunity in Japan, from what i can gather it is theoretical at best."

Did you not understand my last post? There is not evidence of waning immunity in Japan because there is still wild chicken pox circulating to 'boost' immunity. They only give 1 vaccine and it is not compulsory and usually only people 'at risk' get it. Coverage is currently around 30%. In countries where the vaccine is part of the schedule there is not enough of the wild virus circulating to 'boost' immunity which is why they've had to introduce the vaccine booster. (2006/2007)

"and further more for BM who keeps insisting that it is only children with health conditions that get severe CP"

I have certainly not said this. I have said that immunocompromised people and adults are more likely to suffer from serious complications. The paper that Catherina linked to earlier supported that. Also from the NHS:

"Complications of chickenpox are rare in healthy children. The most common complication is where the blisters become infected with bacteria.
...
The people who are most at risk of developing chickenpox complications are:
adults
pregnant women
babies under four weeks old
people with a weakened immune system "

Where did your quote come from?

SO its theoretical and nothing more, you are being deliberately misleading. There was a theory that not having wild chicken pox circulating would increase the cases of shingles. This has now been disproved and it also looks like the varicella vaccine also provides protection against shingles as well.

Complications may be rare but reactions to the vaccine are exceptionally rare. Any fatality is too much whether healthy previously or not. The majority of children (90%) who are hospitalised from chicken pox were previously healthy. In children under 12 (therefore not adults) half of all deaths were healthy children.
In the UK that is 2 or 3 deaths per year in previously healthy children. Someone was unlucky enough to have those 2 or 3 children. 10% of adults will not have had CP as a child, they account for approx 20 deaths a year in the uk.

Yes. DS was fine at first, ended up with one infected, d&v and dehydration and it took him 8 weeks to fully recover (at 20m)

What are you saying is theoretical?

Do you now accept that Japan does not provide evidence of no waning immunity in relation to the booster vaccine (because a booster isn't given there)? Do you accept that the booster was only introduced in the US and Canada in 2006/2007 so we can only say it provides protection for 6 years so far?

I wouldn't say a reaction in 1 in 1900 doses (as quoted by Catherina earlier) is exceptionally rare. You still haven't said where you got your quote from. I would be interested to see where your information is coming from.

90% of all hospitalisations from CP may be in previously healthy people but that is because there are more healthy than immunocompromised people! You would need to compare the rate of hospitalisation of healthy people to the rate of hospitalisation in people with pre-exisiting conditions otherwise it means nothing.

Yes, any death in a child is tragic. I have not said otherwise.

Of course, as long as the CP vaccine isn't routinely given in the UK, people who have been vaccinated will continue to be exposed to wild CP, so until there's a mass vaccination programme the Japanese experience is probably quite a good parallel for us.

Yes, if people do opt for the CP vaccine then it is in their best interests for other people not to so their children's immunity gets naturally boosted. I wonder if they would be called selfish in the same way as people who decide not to vaccinate and get accused of piggybacking on 'herd immunity'?

In any case, with the Japanese approach, 'the epidemiology of natural varicella has not changed greatly since the introduction of the vaccine. " (paper I linked to above) so it's not going to make much difference to the population as a whole. That's pretty much what's happening in the UK anyway - people who want the vaccine get it privately and most people don't.

If (and probably when) the UK do introduce the vaccine then we will face the same problems as the US with requiring a vaccine booster and we do not currently know how long it lasts for as it was only recommended in 2006. I don't think it would be wise to vaccinate children now with the belief that they will benefit from a lifetime of natural boosters from being in the UK.

Exactly Dancewithstrangers. There is small studies that show that there is immunity after 20 years and i havent seen anything since that says there is evidence of waning in Japan.
Another point is that when we get to the point of high vaccination, if there is no wild chickenpox circulating, it makes it harder and harder to catch chickenpox anyway.

BM
again look at the hard numbers ie 2 to 3 deaths in healthy children is too much. The adverse event of 1 in 1900 means a sore arm or a mild rash not severe complications. Life affecting complications to variecella vaccine are so rare that cant compute them.
the conclusion to the report was
Overall, serious adverse events reported after varicella vaccination continue to be rare and must be considered relative to the substantial benefits of varicella vaccination

Bruffin, are you deliberately ignoring all the information I'm posting? Did you read the study I linked to?
I have already explained why immunity is not waning in Japan. You are trying to compare the use of a single vaccine in a country with limited vaccination cover (natural boosters) to the use of a newly introduced booster vaccine in a country with a high vaccination rate and say that this shows it doesn't wane. The fact that a booster dose was introduced in the US shows that the single vaccine approach used in Japan didn't work in a highly vaccinated population. I'm not sure why you find that difficult to understand.

Again, where did you get your information from that you quoted earlier? You keep jumping from one thing to another and ignoring my questions. Do they make you uncomfortable because you don't know the answers/ don't understand?

As far as looking at the numbers goes. Again, if we have the Japan approach (which you seem happy with because of the 20 years with no waning - I noticed that you've reduced this from the 30 years you originally stated) why do you think the epidemiology of the disease will change when it has not in Japan? What approach are you suggesting that the UK should take?

In the UK we have a choice about vaccines. Parents can either pay privately (and take the risks) for a varicella vaccine or they can put up with the risks inconvience of wild chickenpox. As parents we decide what risks we take with our children all the time. Most of us base our parenting decisions on gut feeling, experience as well as research.

My son had a hideous time with chicken pox as he has eczema at the same time. Prehaps its hard to work out whether his cellularitis was chicken pox or eczema caused. I chose to vaccinate dd against chicken pox even though she doesn't get eczema.

So as someone with a vaccinated child in a mainly unvaccinated population (like Japan) would you prefer the situation to remain as it is so your daughter's immunity is continually boosted by contact with the circulating wild virus or would you like the vaccine to become part of the schedule (like in the US) which will result in higher coverage, less circulation of the wild virus and therefore fewer boosting opportunities for your daughter?

I wouldn't mind if the nhs offered chickenpox vaccination to every child. However I think the NHS has greater priorities like offering the mengentitis B jab. MMR take up has been at an all time low and if a fourth vaccination was added to the MMR then it might put parents off.

I would like parents to have the freedom to make their own decisions about vaccination for trival diseases like chickenpox. It is stupid to pretend that chicken pox is as dangerous as measles or whooping cough. Herd immunity is not important for chicken pox and it would be dishonest for health professionals to put parents under huge pressure for healthy children to have the chickenpox vaccine.

In my ideal world I would offer a chickenpox vaccine on the NHS to any teen who has not had chickenpox. I also offer a chickenpox jab to any child who suffers from ezcema or asthma as well as immune compromised families. (which is currently the case) I would also test pregnant women for varicella zoster anti bodies at the same time as they are tested for rubella anti bodies. I would vaccinate anyone over the age of 13 on the NHS who did not have variella anti bodies.

My daughter's immunity to chicken pox can be boosted by vaccine if necessary when she is older. People lose immunity even if they had natural chicken pox.

We seem to have very similar ideas about it RT. :)

Although waning natural immunity isn't really the norm here given that it is constantly circulating. It might become a problem if we did have high levels of vaccine coverage though. Something else to consider...more adults potentially becoming vulnerable to CP again due to the virus not circulating and providing boosters.

I would like low income families to have access to the same choices as I have. Prehaps the variella vaccine should be available from local GP surgeries at cost rather than having to pay £180 to a private company.

I think that single jabs should be available at cost from a GP surgery ensure that all children are vaccinated against measles, mups and rubella.

"Something else to consider...more adults potentially becoming vulnerable to CP again due to the virus not circulating and providing boosters."

I imagine that small children attending nursery are the culprits for giving pregnant women chickenpox. Prehaps vaccinating children will reduce birth defects due to chickenpox. Lots of people who have had wild chickenpox lose immunity to chickenpox in later life.

I think that my vaccinated daugher may have had wild chickenpox, but very mildly. Prehaps vaccinated adults who get chickenpox will have it mildly. Immunity wanes gradually, its not an on/off button.

"Lots of people who have had wild chickenpox lose immunity to chickenpox in later life."

I'm not sure about that RT. Most people with natural infection seem to keep their immunity - I think > 90%. They are getting natural boosters all the time because it is endemic in the UK. I think it would make more sense to test and vaccinate teenagers/young adults to ensure women are covered when they are pregnant.

I am pleased with our choice to vaccinate our children. I felt more information was needed though and I do worry about the long term level of immunity however, they have been exposed so much to wild pox that I am sure their immunity has been built up.