Originally published in The Ottawa Citizen November 14, 2001

Original Title: The new vaccines: How to crash a party

A recent article about parents holding chickenpox parties to intentionally infect their children perpetuates the popular misconception that chickenpox is a benign disease. One of the parents said: “It’s a natural way to deal with the problem, instead of introducing more chemicals into kids.” She was concerned about whether it provided lifelong immunity and erroneously believed that the vaccine had been available for only six years.

The mother expresses a valid concern that deserves to be answered. No parent wants to harm their child. Her actions reflect her desire to minimize the risk of chickenpox should it occur when her children are teens or adults. Indeed, in a broader context, three childhood vaccines have been added to the arsenal in recent years.

Chicken pox is caused by the Varicella Zoster Virus. By age 20, 95 per cent of us have had the disease. The complications of this disease include skin and soft tissue infection, ear, eye, nose and throat infections, serious bacterial infections like necrotizing fasciitis (the flesh eating disease), pneumonia, encephalitis and meningitis.

According to Dr. Steven Moss, assistant professor of pediatrics at the University of Toronto, chickenpox complication rates are one in 75. In Canada last year, 2,000 children were admitted to hospital. Twelve died. More than 90 percent of these children who contracted chickenpox were healthy.

The live attenuated vaccine (weakened live virus) has been used in Japan and in the United States for 27 and 13 years respectively. More than 20 million doses have been given. The vaccine’s side effects are a two to five per cent chance of a low-grade fever and three to six per cent chance of a local rash at the injection site. No other side effects have been reported.

The vaccine will provide complete protection in 90 to 95 per cent of those vaccinated. The remaining five to 10 percent will have partial immunity. The partial responders will experience about 30 pox marks instead of the average 350. It will continue to reduce their complication risk and disease severity. The data suggests that it will provide lifetime immunity. Once somebody has had chickenpox, their lifetime risk for developing shingles, a large bubbled painful rash, is 20 per cent. If vaccinated, the risk falls to .000015 per cent.

The Hepatitis B virus infects the liver. It is extremely contagious and easier to catch than the AIDs virus, HIV. It is found in every body secretion and can be transmitted through sexual activity, contaminated needles, tattooing, breastfeeding, toothbrushes and razors.

It is a hardy virus. You can take a syringe containing the virus, bury it, let it sit underground all winter, dig it up in the spring, add water and presto! You now have active Hepatitis B virus.

One of my 18 month-old patients picked up a syringe they found in a park and put it in her mouth. The syringe was indeed contaminated with Hepatitis B.

Approximately 300 to 350 million people are chronic carriers of this disease. In Canada about one person in 200 is a chronic carrier. There are 20,000 new infections each year. About ten per cent become chronic carriers. The exposure of newborns to this virus can result in liver cancer later in life nine times out often.

The vaccine contains pieces of the protective shell that surrounds the virus. The Hepatitis B virus is not present in the vaccine. There are few if any side effects and it provides at least ten years of immunity and probably much longer in 95 percent of all recipients.

Prevnar (Pneumococcal vaccine) was approved for use in Canada on June 25 and is recommended from birth to nine years of age. This is the first vaccine that is able to protect young children from the Streptococcal pneumonia bacteria. It contains pieces of the bacterial shell.

This organism causes blood infections, meningitis, pneumonia, middle ear and sinus infections. It is the most common cause of meningitis in children in the United States.

In children under two years of age, the incidence of pneumococcal meningitis is approximately .0007 per cent. Death occurs in eight per cent, brain damage in 25 per cent and hearing loss in 32 per cent of children with meningitis. It is responsible for 20 to 40 per cent of all middle ear infections. Antibiotic resistance to this organism is on the rise worldwide.

The most common side effects of the vaccine are pain, redness and swelling at the injection site. These vaccines offer more protection for our children. My two boys have been vaccinated against all three diseases. Chicken pox parties will continue but at least parents now have other options.

© Dr. Barry Dworkin 2001