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Chickenpox or Vaccine: A Choice?

by Mark A. Goldstein, M.D., Chief of Pediatrics and Student Health

The Story on Chickenpox

Chickenpox is in the news, and for a happy reason. There is now a vaccine to prevent the disease. The moment you hear this fact, two questions probably come to mind:

1. Should your children (if you have children) be vaccinated?
2. Should you and other older family members be vaccinated?

First, a few words about chickenpox in children. Here's the best description I've seen: "Chickenpox is most commonly an annoying illness lasting three to seven days, and happily never seen again." Usually the worst part about it is that a parent has to lose a few days of work caring for the child. The best part--and it is a very good part--is that having chickenpox gives you lifelong immunity. Once you have had chickenpox, you will never get it again.

In adults, the story is a little less pleasant. Most grownups in the United States (more than 90 percent) have contracted chickenpox in their childhood, and so are permanently immune. However, many may not know that they had the disease if it was a mild case. The other 10 percent clearly have reason for concern. Chickenpox in an adult can be a serious disease. Fortunately, there is an effective treatment for it: the anti-viral medication acyclovir.

Now comes the vaccine

This is the first approved vaccine for a disease that is (generally) not life-threatening. It has been in use in Japan for more than ten years, so we know that it is safe for most people. (It should not be administered, though, to anyone who is pregnant, or who is hypersensitive or allergic to certain particular substances, or who has an impaired immune system.)

There is talk that eventually the chickenpox vaccine will be required for all children. For now, the decision is up to the parent.

No one knows whether the immunity given by the vaccine will wear off in later life. It is possible that booster shots will be necessary. If so, people who received the vaccine as children--and who then as adults neglect to have booster shots--could become susceptible to chickenpox. And remember that although chickenpox is not usually dangerous for children, it can be a severe disease for adults.

And so, for everyone, the question is whether to vaccinate or not. Here are some things to consider:

For children

• In children, chickenpox is annoying, but rarely dangerous.
• Having the disease does give a big benefit: lifelong immunity.
• We don't know if the vaccine gives lifelong immunity. After a vaccinated child grows up, if he or she neglects to have booster shots, there could be a risk of contracting chickenpox as an adult--when the disease could be much more severe.
• We recommend: talk it over with your personal physician or pediatrician.

For adults

• If you have ever had chickenpox, you are immune for life.
• For an adult who has never had it, chickenpox can be a serious disease.
• If you anticipate becoming pregnant, be aware that chickenpox during pregnancy could lead to severe problems for your child.
• If you have never had chickenpox, talk with your personal physician.

Special considerations for college students

• When people reach college age, chickenpox is an increasingly serious disease.
• In a college living environment, chickenpox can spread more easily than elsewhere.
• If you contract the disease, expect to be in the infirmary for a week or more.
• If you have never had chickenpox, talk with your personal physician.

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ALL INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR LEGAL ADVICE.  THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.