Should all children have the chickenpox vaccine?
Publication Date:08/11/2007
Vaccinating all young children against chickenpox is the only way to prevent serious complications and deaths from this illness, according to a new study.
What do we know already?
Many people see chickenpox as a normal part of childhood. It's uncomfortable and unpleasant, but children usually recover in about a week.
Chickenpox is more serious in adults, young babies and people with a weak immune system. And if a pregnant woman catches chickenpox, it can be dangerous for her baby.
Two brands of chickenpox vaccine are available in the UK, but they're not used routinely. They're only recommended for healthcare workers and people in regular contact with someone who has a weak immune system.
Between 2 and 5 in 1,000 children with chickenpox end up being treated in hospital, but serious problems are rare. Researchers have now looked at exactly how often serious problems happen, to see whether the chickenpox vaccine should be more widely available.
What does the new study say?
Doctors in the UK and Ireland were asked to report all serious cases of chickenpox for a year. The number of children who got serious health problems because of chickenpox was less than 1 in 100,000. The complications the children had included pneumonia, blood infections or inflammation in the brain.
It's extremely rare for children to die of chickenpox. The researchers found six deaths over a year, out of all the children under 16 in the UK and Ireland. Four of these children already had serious illnesses that made them more vulnerable.
Most of the children who became seriously ill had been in good health before they got chickenpox. So there's no way to predict which children are at risk. The researchers think that, to prevent serious complications, all children would need to be vaccinated.
In the US, the chickenpox vaccine helped to cut down the number of deaths when it was introduced in 1995. The number of people dying of chickenpox dropped from 4 in every 10 million between 1990 and 1994, to just over 1 in 10 million between 1999 and 2001.
Where does the study come from?
The study was done by researchers from several hospitals and universities in England and Australia. Three of the researchers were based at Health Protection Scotland, which works to find ways of preventing health problems. It appeared in the medical journal Archives of Disease in Childhood, which is published by the BMJ Group.
What does this mean for me?
There aren't any firm plans to make the chickenpox vaccine routine in the UK, although the committee that advises the government on vaccines is due to discuss the chickenpox vaccine at the end of this year.
If the chickenpox vaccine were introduced, it could be given to children on its own, or added to the measles, mumps and rubella (MMR) jab. Although research has overwhelmingly found that MMR doesn't cause autism, many parents still worry about it. So adding another vaccine to MMR could be unpopular.
Another option would be to vaccinate teenagers who didn't get chickenpox as children. This would help stop them going on to get chickenpox as adults, which is often worse than getting it as a child. But it wouldn't prevent serious complications or deaths in children.
There are some problems with introducing a chickenpox vaccine. Some doctors think it could increase the number of adults who get an illness called shingles. Even after you've recovered from chickenpox, the virus stays in your body. It can be reactivated years later, causing shingles. If you're in contact with the chickenpox virus from time to time, such as when your children get it, it acts a bit like a booster vaccine, and prevents shingles. But if all children were vaccinated against chickenpox, adults wouldn't get that boost to their immune systems.
Side effects of the chickenpox vaccine seem to be rare, although there's a small risk you could pass on chickenpox to other people after you've been vaccinated.
What should I do now?
If you're a healthcare worker or you have close contact with someone who has a weak immune system, you can talk to your doctor about getting the chickenpox vaccine. At the moment, the vaccine isn't recommended for anyone else.
Children who get chickenpox need to be kept off school until their rash has crusted over. This usually means missing about a week of school. A child who is feverish can be given paracetamol, and you can use calamine lotion or another type of cream to reduce itching. Ask your pharmacist for advice.
If you're pregnant and you haven't had chickenpox before, you should avoid contact with anyone who has chickenpox or shingles. If you do come into contact with one of these illnesses, see your doctor straight away.
From:
Cameron C, Allan G, Johnston F, et al. Severe complications of chickenpox in hospitalised children in the UK and Ireland. Archives of Disease in Childhood. Published online 8 November 2007.
To read more, see our information on chickenpox.
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© BMJ Publishing Group Limited ("BMJ Group") 2007. All rights reserved
This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.
