Friday, July 16, 2004

Chicken Pox vaccine: To give or not to give

About the CHICKEN POX Vaccine:

Varicella vaccine has been available since in Japan since 1985, and in the US since 1995, and is approved for use in healthy children 12 months of age or older, and susceptible (i.e., no evidence of having had chickenpox in the past) adolescents and adults.
Varicella vaccine is highly effective in protecting against severe chickenpox.
More than 6 million doses of varicella vaccine have been given since it was licensed in March 1995.
It is recommended by the American Academy of Pediatrics  that all children be routinely vaccinated at 12-­18 months of age and that all susceptible children receive the vaccine before their 13th birthday.
The Indian Academy of Pediatrics has the following statement on its website for both Chicken pox & Hepatitis A vaccines;
At present IAP committee on Immunization consider these vaccine as additional vaccines. However, both are excellent vaccines- highly efficacious and very safe.
A history of chickenpox is considered adequate evidence of immunity, with no vaccination needed.

Isn't my child better off getting chicken pox and having permanent natural immunity than risking side effects and getting only partial immunity from the vaccine?
Answer: Probably not. Some doctors may still advise you to wait and see whether your child gets chicken pox by age 10 before having her vaccinated, but there's not much logic behind this advice any longer. The idea was that the vaccine was still pretty new (it came out in 1995 in the US, 1985 in Japan) and we didn't know much about its effectiveness or side effects, whereas chicken pox itself was generally thought to be a mild disease that most kids got through with only a little itching.It's true that the vaccine won't guarantee that your child will never get chicken pox — about 10-15 percent of those vaccinated may still get a very mild case, with no fever and fewer than 10 blisters. And experts can't be sure that the immunity it offers is permanent. But we do know that the chicken pox vaccine has been used in Japan for about 25 years with no evidence of fading immunity. We also know that shingles (a painful and disfiguring rash caused by the same virus) is less common and less severe in people who have been vaccinated than in those who actually had chicken pox as kids.
And as with all vaccines, a certain number of children will experience mild side effects. Up to 20 percent of children will have pain where they received the shot, about 10 percent will have a low fever, and about 4 percent will have a mild rash. But there has never been a serious adverse reaction linked to this vaccine.
On the other hand, chicken pox is not always a mild illness. Of the 3 to 4 million U.S. children each year who come down with it, one in 1,000 will develop complications such as severe pneumonia or a brain infection called encephalitis, and about 50 will die. Children with chicken pox are also more susceptible to "flesh-eating" streptococcus infections, although those infections are quite rare.
This information came to you courtesy the babycenter!
As of now 2 brands of Chickenpox vaccines are available in India, Varilrix by GSK & Okavax by Aventis. The basic difference according to manufacturer’s literature is that while Varilrix requires 2 doses after 13 years age, Okavax can be given in a single dose for all ages.

So what is my Opinion regarding the vaccination?
Answer: If you can afford it, take it! Recent data suggests that Chicken Pox vaccine may be more effective if taken at 15-18 months rather than 1 year, so ask your pediatrician to give it at 15 months.   
More india specific vaccine information at Charak Clinics




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