Daniel Highkin, MD
The Vancouver Clinic, Vancouver, WA, USA

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Re: Data are a persuasive argument against mass vaccination

Email Daniel Highkin, MD:
dhighkin@thevancouverclinic.com

The authors conclude that there are not persuasive arguments for mass vaccination. In fact, I think that their data provide persuasive argument against such mass vaccination programs as we have here in the USA.

The study demonstrates that 19% of the cases, but 81% of the deaths, are in adults, which is consistent with earlier data. Varicella is much more likely to be lethal among adults than among children.

As with other vaccines, one would expect the immunity from V-Z vaccine to wane in 15-20 years. Thus, if we vaccinate children we will have a large cohort of young adults who are not immune to chickenpox, unless they all come in to get boosters. This seems unlikely, given the low likelihood of regular doctor visits for people in their 20's. However, there will still be a large reservoir of potential exposure to the virus in the form of Herpes Zoster. Thus, there is the potential for large-scale exposure of non-immune young adults to the varicella-zoster virus if there is a large vaccination program.

It would be far preferable for people to be exposed naturally to chickenpox and perhaps reserve the vaccine for those who reach young adulthood without getting chickenpox.