2-dose varicella vaccine regimen – decline of chickenpox

varicella vaccine

The varicella vaccine for chickenpox was introduced in the mid-1990’s in the USA and has been associated with substantial and statistically significant declines in incidence, hospitalizations and deaths attributable to chickenpox.

Despite the beliefs of vaccine refusers, who  have stated emphatically that chickenpox is not dangerous, the real complications from a varicella infection are numerous and serious:

  • dehydration
  • pneumonia
  • bleeding problems
  • infection or inflammation of the brain (encephalitis, cerebellar ataxia)
  • bacterial infections of the skin and soft tissues in children including Group A streptococcal infections
  • blood stream infections (sepsis)
  • toxic shock syndrome
  • bone infections
  • joint infections

Let’s take a look at the facts – the varicella vaccine has actually lead to a significant reduction in the incidence of chickenpox in children.

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Vaccination coverage in US children,19-35 months–uptake still high

The United States Centers for Disease Control and Prevention (CDC) has reported in the 2012 National Immunization Survey (NIS) that the majority of children, age 19-35 months, remained extremely high from 2008 through 2012, although there was a small, but statistically significant drop in uptake of some vaccines from 2011 to 2012. In addition, the CDC specified a substantial concern about clusters of unvaccinated children in widespread communities that are at risk from vaccine preventable diseases, and may pose a health risk to the community at large.

The study results were based upon a survey (cell and land-line phone calls with follow-up details from the health care provider) of about 16,000 children (an extremely large sampling for a survey). The data was then adjusted for racial/ethnic, income, and other population factors. Even though the CDC provided data from 2008-2012, the current method of polling was started in 2011, and only results from 2011 and 2012 are mathematically comparable.

vaccine-uptake-2013-2012

 

 

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Despite activities of vaccine refusers, nearly all kids immunized

The United States Centers for Disease Control and Prevention (CDC) reported that most kindergartners in the United States received their recommended vaccines for measles and other diseases during the 2012-2013 school year. However, the CDC also mentioned concern about unvaccinated clusters of children that are at risk from vaccine preventable diseases, and may pose a health risk to the community at large.

Overall, 48 states and DC (as well as 8 US jurisdictions, including Guam, Puerto Rico and other territories) reported 2012-13 school vaccination coverage. Approximately 94.5% of kindergartners had received their complete MMR vaccinations, an insignificant drop from the 2011-12 level of 94.8%.  DTaP coverage was 95.1%, above Healthy People 2020 target of 95%. For the varicella vaccine, 93.8% of American kindergartners received both necessary doses.

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Consequences of not vaccinating a child–Report 1

pox partyVaccine deniers love to say that many (and some say all) vaccine preventable diseases are not dangerous, so why even take a tiny risk of an adverse event with vaccines to prevent these innocuous, harmless diseases. The problem with that belief is that it is simply untrue.

The CDC reported last week about a previously healthy 15 year old girl in Ohio who died from a chickenpox (Varicella zoster virus), a disease that is generally prevented by the varicella vaccine. The adolescent girl was admitted to a hospital after three days of a rash consistent with chickenpox with the last day experiencing fever and shortness of breath. The young girls was started on antibiotics and antifungals, to treat any concurrent infections, but she died three weeks later. The girl was current (or close to current) on her other vaccinations, MMR, DTaP, and Hib, but lived in an area that with low uptake of varicella vaccinations. Because deaths from chickenpox are so rare (about 100 people die of chickenpox every year in the USA), but not unknown, the Ohio Department of Health undertook a thorough investigation and concluded that the girl died from chickenpox, and there were no other comorbidities, including leukemia (which might have suppressed her immune system).

The complications from chickenpox occur mostly in susceptible groups such as infants, pregnant women, and immunocompromised individuals. Some of the more serious complications are:

  • dehydration
  • pneumonia
  • bleeding problems
  • infection or inflammation of the brain (encephalitis, cerebellar ataxia)
  • bacterial infections of the skin and soft tissues in children including Group A streptococcal infections
  • blood stream infections (sepsis)
  • toxic shock syndrome
  • bone infections
  • joint infections

It was very difficult to read the article. Most of the young girl’s organs failed, and she was in respiratory distress when she died. I cannot imagine being a parent watching what happened over three weeks while she was in the hospital. I can only imagine that the parents are beating themselves up over not having her vaccinated.

For those parents who are engaging in Pox Parties, where parents deliberately infect their children with flu, chickenpox and other vaccine-preventable diseases, understand that you might be putting your child at risk of dying. Please don’t do it.

Vaccines do save lives. 

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West Virginia tough on vaccine exemptions

The state of West Virginia (WV) has one of the toughest child vaccination regulations in the United States, not allowing any religious exemptions to vaccinations required before attending school. Only Mississippi has regulations this strict for allowable exemptions. Of course, as I have written, religious exemptions have been abused by vaccine deniers by creating “fake” religions so that parents’ antivaccination beliefs will be recognized by the state. In fact, only medical exemptions are accepted by the state (pdf), and their standards on who can meet the medical exemption are quite tough.

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Failure of vaccine denialism–most US kindergarten students are vaccinated

The United States Centers for Disease Control and Prevention in its Morbidity and Mortality Weekly Report (MMWR) for August 24, 2012 reported that most kindergartners in the United States received their recommended vaccines for measles and other diseases during the 2011-12 school year but that unvaccinated clusters continue to pose a health risk. Overall, 47 states and DC reported 2011–12 school vaccination coverage, median MMR vaccination coverage was 94.8%, with a range of 86.8% in Colorado to 99.3% in Texas. Four states reported <90% MMR vaccination rates: Colorado, Idaho, Kansas and Pennsylvania. Continue reading “Failure of vaccine denialism–most US kindergarten students are vaccinated”

Debunking the “vaccines aren’t tested” myth

There are so many silly memes that have arisen from the anti-vaxxers, all of which have been thoroughly debunked. Everything from the well-worn (and worn-out) “vaccines cause autism” fable, quashed here, to the “these diseases aren’t dangerous”, which, of course, couldn’t be farther from the truth. One of the more annoying of the tales pushed by the vaccine denialists is that vaccines aren’t tested thoroughly before being used on unsuspecting infants. I do not know where this started, or why it started, but like much in the anti-vaccination world, it really doesn’t matter. It just passes from one person to another across google, and individuals with no research background hold this particular belief as if it were the Truth™. Continue reading “Debunking the “vaccines aren’t tested” myth”

Anti-vaccine lunatic proud to spread infection to unsuspecting children

That is a screen shot from a Facebook posting on July 14, 2012 where a mother describes how she took her child, infected with chickenpox (Varicella zoster), to a baseball game. And she bragged how she probably infected others (probably most were vaccinated, which indicates he level of understanding of immunizations). She was so proud of attempting to infect others with her son’s chickenpox that she had to tell everyone about it. The stupidity of her actions were beyond comprehension by me. Continue reading “Anti-vaccine lunatic proud to spread infection to unsuspecting children”

Parents put immunocompromised child at risk by not vaccinating sibling

Chickenpox, or Varicella zoster, is a common childhood disease that can result in fairly serious complications such as encephalitis, pneumonia, sepsis, hemorrhagic varicella, and death. Individuals at especially high risk from complications from varicella are immunocompromised, usually from some sort of immunodeficiency or immunosuppression (usually pharmaceutical treatments for cancers or autoimmune diseases). For immunocompromised individuals, it is important that any individuals around them should be vaccinated against common childhood diseases, whether chickenpox or other diseases (mumps, rubella, etc.), because the chances of transmitting these diseases is extremely high and the risk of complications are serious.

The Centers for Disease Control and Prevention reported that a 3 year old Minnesota girl, who was receiving immunosuppressive therapy for juvenile rheumatoid arthritis, was admitted to a hospital after 2 days of a high fever of 102.7°F (39.3°C) and extensive rash, including in her mouth and throat. Neither she nor her younger sibling received the first dose of varicella vaccine (recommended at 12-15 months) because their parents refused the vaccinations as a result of personal beliefs. The child eventually recovered as a result of treatment with intravenous acyclovir (which has more serious potential side effects than the imagined ones for the vaccine). Continue reading “Parents put immunocompromised child at risk by not vaccinating sibling”

Chickenpox outbreak in Florida

According to Vaccine News Daily, Chickenpox spreads to five Fla. public schools, the chickenpox (Varicella zoster) outbreak in Florida is increasing in size:

Health officials in Florida added 25 students who are not vaccinated against chickenpox to a list of those barred from attending class in five public schools in High Springs and Alachua on Wednesday.

There have been 65 cases of chickenpox reported in the northwest part of Alachua County, prompting the health department to prohibit unvaccinated students from attending the Alachua Learning Center.

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