Tuesday, May 13, 2003

BY SUSAN K. LIVIO
Star-Ledger Staff

New Jersey's plan to require that children be vaccinated against chickenpox inched closer to enactment yesterday, despite opposition from parents worried about potential side effects from the shot.

During a contentious public hearing in Trenton, several parents and a physicians group urged the state Public Health Council to rescind the proposal, which would make New Jersey the 38th state to require children to get the chickenpox, or Varicella, vaccine.

The parents conceded, however, that they are unlikely to sway the council, which voted unanimously in December to mandate the vaccine for toddlers who are at least 19 months old and attend day care, and for children born after Jan. 1, 1998, who are entering kindergarten or first grade.

Yesterday's hearing clears the way for the council, the state's rule-making body on public health matters, to take a final vote on the plan and send it to Gov. James E. McGreevey.

As states have considered mandating the chickenpox vaccine, parents and lawmakers have debated what poses a greater risk -- the disease or the vaccine.

"Parents must continue to have a choice as to whether or not their children receive this vaccine," said Sue Collins of Long Hill Township, Morris County, assistant director of the New Jersey Alliance for Informed Choice in Vaccination. "Chickenpox is generally a mild disease in childhood. Are we serving to delay this disease into adulthood when vaccine immunity wanes, when the consequences are much more serious?"

Parents also questioned whether going after childhood chickenpox increases the odds of contracting shingles -- a painful, herpes-like virus related to chickenpox -- later in life. Citing a decade-old study from Asia, the parents argued that the potency of the vaccine wanes after 10 years.

But according to the U.S. Centers for Disease Control and Prevention, "available information from healthy children and adults" suggests that shingles is less common in healthy people who received the chickenpox vaccine than in those who had chickenpox.

"Chickenpox is not an illness that New Jersey needs a mandated inoculation," said Catherine Millet of Point Pleasant, the mother of three. "Such mandates ought to be reserved for matters of genuine public peril."

Robert Morgan, a pediatrician and consultant to the state Department of Health and Senior Services, said chickenpox is not always a benign childhood illness. In an interview after the hearing, Morgan said that even without a state mandate, about 80 percent of parents in New Jersey voluntarily get their children vaccinated against chickenpox.

Chickenpox has a characteristic itchy rash, which then forms blisters that dry and become scabs in four to five days, according to the CDC. A fever and general malaise may follow and is usually more severe in adults. In rare cases, the illness can cause brain swelling, pneumonia and skin infections, according to the American Academy of Family Physicians. In 1999, 48 people died from chickenpox.

Serious side effects from the vaccine -- including seizures, brain infection and pneumonia -- have occurred in 1 in every 50,000 doses given, according to the CDC Web site. "It is important to note that the risks from the vaccine remain much lower than the risks from the disease," the CDC said.

Morgan said respected agencies that encourage the vaccination, including the CDC and the private National Institutes of Medicine, "have no vested interest in spinning the data they receive."

Not all physicians and research scientists have embraced the chickenpox vaccine.

Speaking on behalf of the Association of American Physicians and Surgeons, attorney Andrew Schlafly of Far Hills said the vaccine, approved by the federal government in 1995, is "still relatively new and unproven, both in safety and efficacy."

"Forcing millions to receive this vaccine, at substantial expense, would constitute an experiment on the public," Schlafly said.

Parents also cited an article that ran in the British journal Vaccine last year that predicted that eliminating chickenpox in a nation the size of the United States would cause as many deaths as it would prevent. The journal suggested vaccines would prevent 186 million cases of the chickenpox and 5,000 deaths over 50 years. But it said they also would prompt 21 million more cases of shingles and 5,000 deaths.

The testimony will be evaluated by the health department, then published in the New Jersey Register, a biweekly journal that lists all pending and adopted state rules. The council will have one more public hearing on the day it will cast a vote. That date has not been determined.

The vaccine is mandated in 37 states and the District of Columbia, according to the National Conference of State Legislatures.