Does Adult Need
Chickenpox Vaccine?
I
am a 35-year-old female wondering if I should get the varicella vaccine.
My mother doesn't think I had chickenpox as a child. When I was 24, I
had a varicella titer that showed I had "borderline immunity." I have a
seven-year-old daughter who has never had the vaccine either. I work in
a patient-care area of a hospital as a secretary. Do you think I should
get a varicella vaccine? Since I'm an adult, could I have a reaction to
the vaccine that might be just as severe as getting the disease? I am a
little hesitant because when I received the rubella vaccine at age 20 I
became quite ill with a fever and swollen lymph nodes. My doctor says it
doesn't matter whether I get vaccinated, but our pediatrician wants me
to. I am very confused.
Maureen
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Harold Oster

Dr.
Oster is an infectious disease specialist at Scripps Clinic Medical
Group in San Diego, California.
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Between
3 million and 4 million people develop varicella (chickenpox) each year
in the United States alone. It is usually a harmless childhood disease
that gets better on its own. However, the infection can have many
important consequences. The varicella virus, reactivating later in life,
causes shingles, a painful blistering rash on the trunk or face. In rare
cases, children with chickenpox can develop serious complications,
including pneumonia, encephalitis (brain infection) or hepatitis (liver
infection). Another complication is serious strep infection of the skin
developing at the site of one of the blisters. When adults get varicella,
the complication rate is much higher. Pneumonia is much more common in
adults and can be especially deadly in pregnant women. In addition, if a
woman develops varicella near the time of delivery, she may pass it to
her newborn, who then has a high risk of serious, even fatal disease.
In addition to the
medical complications, the virus causes a great financial burden. As
many as half a million physician visits each year are due to the
disease. The amount of lost wages for the parents of ill children is
staggering. Because of the economic implications and the occasional
complications, researchers developed a vaccine to prevent varicella.
This vaccine contains weakened but still "living" virus, and it is very
effective, somewhat more so in children than in adults. It is approved
for use in all children, and most babies today receive it.
There is still some controversy regarding the vaccine, however. Some
feel that if the vaccine is given to every baby, and if its
effectiveness wanes over the years, then many adults of that generation
will be susceptible to the virus. Since the disease is much more severe
in adults than in children, that would lead to more-serious infections
in the long run.
What should you do? I
think you should definitely consider the vaccine. Since you work in a
hospital, you will be exposed to the virus and are at risk of exposing
others, including the immune-compromised, who are particularly
susceptible to the infection. (The only contraindication to the vaccine
is if you have a serious immune deficiency such as AIDS.) If I were you,
I would first be tested again to look for antibody to varicella. If the
test is positive, then you have had chickenpox and are immune to further
infection. In that case, you would not need the vaccine. If your test is
negative, I would get the shot. (In fact, I was in this situation, as I
had never had chickenpox either. I chose to get vaccinated.)
I would not worry too much about the side effects of the vaccine. I
do not know why you may have had a reaction to the rubella vaccine, but
I don't think it puts you at increased risk for reactions to this
vaccine. You certainly should not expect a reaction to be anywhere near
as severe as getting varicella. The most common side effects are fever
and a few small blisters on the skin.
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| by Harold Oster |
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.
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