Today a Seattle mom advertised on an online parenting community that both of her children had chickenpox and then invited (non-vaccinated) children over for exposure. That’s the invite from 1:19pm today.
It turns out people are still having chickenpox parties.
Part of this makes my head spin. I just don’t get it, despite having had many families in my practice decline or hesitate or delay the chickenpox shot. I don’t think parents know what virus they are dealing with. After I posted this invitation on Twitter, I had physicians all over the country sharing stories (some included below).
Chickenpox can cause serious infection complications and rarely it can be lethal. Before the vaccine was approved and put into use in 1995, hundreds of children and adults died in this country every year from chickenpox and thousands were hospitalized. Although most young children get chickenpox and recover (only left with pox or scars) some children develop life-threatening secondary infections. Some children develop severe pneumonia (1 in 1000 children), some develop brain infections, and some children develop flesh-eating bacterial infections in their scabs that can even be fatal.
There is a safe, highly effective vaccine for chickenpox: Varicella Vaccine.
After I saw the pox party invite this afternoon I became slightly enraged. I mean, there are NUMEROUS children and adults in our community immunosuppressed and/or on chemo that could develop life-ending complications if exposed to varicella. And some families are intentionally exposing their children to a potentially harmful infection. After 2 doses of the chickenpox shot (varicella) 99% of patients are immune to chickenpox. Although some children can get chicken pox once vaccinated, they typically only have a few pox and do not develop severe side effects or die.
The pox party just shows me how much work we have to do to build trust in vaccines and vaccine-safety. My boys have both had 2 doses of the varicella vaccine. I’m thrilled they are protected and unlikely to ever get chickenpox or spread it to a community member who could be more at risk. They likely won’t get shingles, either.
Chickenpox Facts & Stats:
- Varicella shots hurt upon injection (children tell me it really stings). We give the shot twice, once at 1 year of age and once at 4 years of age. The shot can commonly cause arm soreness and lowgrade fever. In less than 5% of children, a small rash develops, often around the site of the shot. That’s a good sign the immune system is being triggered to fight off future infections. The rash that can develop after the shot is not contagious.
- Live chickenpox is super contagious. I love this stat from CHOP Vaccine Education Center: take 100 people, put them in a room with one infected person with chicken pox and let them talk for a couple hours. Over that time, 85 of the 99 people will get chickenpox.
- Children with chickenpox are contagious for a day or 2 before the pox appear. That means your child with a lowgrade fever and runny nose could go to school for a couple days, expose hundreds, and then present back at home as having chickenpox a couple days later when the pox develop.
- The varicella vaccine is a live-virus vaccine that induces protection in a similar way to vaccines against measles, mumps, and rubella. Therefore, because the vaccine creates copies (around 20) of the virus to stimulate immunity, our bodies respond like we’ve been infected; protection is likely to be lifelong. A study published today in Pediatrics found that after even 1 dose of the shot, immunity was long-lasting, “This study confirmed that varicella vaccine is effective at preventing chicken pox, with no waning noted over a 14-year period.” Ongoing surveillance of lifelong immunity in vaccinated children and adults will continue through our lifetimes.
- Shingles is a re-awakening of varicella infection (painful blisters that follow path of a nerve), often in those over age 45 years or those who have weakened immune systems. People who have had the varicella shot (versus the infection) are far less likely to get shingles.
- A teenager or adult who has never had chickenpox should get the vaccine.
- If your child is exposed to chicken pox, call your pediatrician and you can come in for the 1st or 2nd shot if they haven’t yet had them.
- Pregnant women who get varicella can pass on risks to unborn babies. One out of every 50 women who gets chickenpox during pregnancy will have a child with a birth defect.
Here’s what some other doctors had to say today when I posted the pox party invite:
I vaxed my child against chicken pox (my dad had permanent eye damage after getting shingles) but I am curious about one thing. If people are dead set against vaccinating for chicken pox isn’t this a better option for them rather than risking getting it later in life and therefore risking having more complications? Won’t it be worse for those kids to get it later in life? I can’t imagine why anyone would take that risk but it is their choice even if it is an ill informed and /or selfish choice.
Wendy Sue Swanson, MD, MBE says
Chickenpox infections are more serious after adolescence and into adulthood–you’re right. The vaccine is safer than the infection. And I don’t know that I can say that it’s a better choice to expose a child to an uncomfortable and potentially complicated infection. I just can’t say I think anyone should do this.
Once a child turns into an adult (age 18) they can get the shot as needed to protect themselves. I’ve had teens in my office start to get shots during adolescence to protect themselves after their parents delayed them during childhood. This is especially important for teen girls who may become pregnant…
Thank you for the reply! I just can’t see a down side to this vaccine at all. I only wish I would have had the option when I was young but will for sure vaccinate for shingles when my time comes. That isn’t a walk in the park either.
Regine Webster says
Thanks for bringing this important issue up – the party idea is just chilling and I’m always baffled to see this kind of thing come up in Seattle of all places (with such incredible health care facilities, research, the Gates Foundation). Have you ever written a blog on herd immunity? I have my own opinions that include terms like “morally reprehensible” but would love to hear your likely more grounded thoughts!
Wendy Sue Swanson, MD, MBE says
Hi Regine, I have written about herd immunity many times but never as a topic in and of itself. However I did write this post a few years back called, 2 Questions For Your School On Community Immunity: https://www.wendysueswanson.com/2-questions-for-school-on-community-immunity/
Perhaps another one is needed. Just yesterday in clinic one of my partners said that recently the reason that many vaccine-hesitant families ended up getting their kids immunized in their growing practice was because of the herd and those vulnerable.
But I’ll tell you, I will educate families about responsibility, vulnerable members, etc and they will still refuse. That’s how scared they are about safety.
Lori T says
Normally I’m 100% pro vaccine, and my son is up to date on all of his shots.
I have been unconvinced about the Chicken Pox vaccine and torn between exposing him to it, or protecting him from it until he’s old enough to get the vaccine.
As I’d understood it, young children who get Chicken Pox get the annoying pox and a fever and go on to recover never to get it again, unless it re-emerges as Shingles later in life.
I’d heard that the vaccine isn’t 100% effective, and if you get Chicken Pox later in life it’s really dangerous and life threatening.
As I said I’m pro vaccine, and I know none are 100% effective, but I worry about him being left unprotected against a life threatening virus later in life, even though he got the vaccine and we assumed he’d be safe. Not when just getting Chicken Pox as a kid is relatively benign and from that he gets definite protection.
If you get the vaccine and it doesn’t end up being 100% effective if you then catch Chicken Pox as a teen or adult is it life threatening the same as if you hadn’t been vaccinated?
I don’t know if my questions make sense, but this is the one vaccine I have serious questions about, as a parent.
Wendy Sue Swanson, MD, MBE says
Hi Lori, Click on the links in the post to read more from the CHOP Vaccine Education Center.
The study linked to in the blog post would likely help as well—
The data thus far, and the science of the vaccine, make it v unlikely that the shot will “wear off” and put children at risk later in life. Lifelong immunity is what the shot was designed to make and thus far, it appears it is doing so.
If, for example, there are concerns 20 years from now about the immunity wearing off, a booster dose will be recommended. But that’s not what scientists predict.
Check here for genereal science info: https://www.chop.edu/service/vaccine-education-center/a-look-at-each-vaccine/varicella-chickenpox-vaccine.html
And here for study info on long-lasting immunity: https://pediatrics.aappublications.org/content/early/2013/03/27/peds.2012-3303.abstract?papetoc
Tracey S. says
Lori, my friends daughter had both doses of the vaccine and did end up getting chickenpox. However, she never had a high fever (99) and had one or two spots, and was out of school only because she was still technically contagious but not because she was miserable. My husband had chickenpox twice, the second time when he was 20 or so and felt horrible with a high fever but only had a couple of spots. Neither had immunity but the vaccinated one had milder symptoms.
Charlie Powell says
So for the attorneys out there; at what point does intentionally infecting a child with a virus like this with known lifelong persistence and sequelae constitute criminal child neglect or abuse? Or how about the civil side? Now counselor bear in mind, the vaccine is much safer and more effective than an intentional infection and it is readily available. Even if a negative vaccine event occurred how is that any different than say a seat belt injury that can occur even when employed properly? And know too, that the refusal to vaccinate also puts a burden on maintaining public health for any number of others who may be susceptible in our society to this otherwise completely preventable risk. Your profession seems to have a duty to protect children with peanut allergies with litigation so why not here? Would you accept a client injured by a chicken pox infection if they pursued damages against their parents?
At what point should we involve the lawyers for parents intentionally injecting their children with mercury, aborted fetus tissue, potential allergens (eggs), and other fun things?
Stop fear mongering. Chicken pox isn’t dangerous for children who aren’t immunocompromised.
I totally agree.
As a Varicella refuser, I regret my decision now. I wanted
to find a chickenpox party up until January and now I hope and pray
none of my kids come down with chickenpox before I can get them
vaccinated. I wish that during my daughters ongoing health
challenges, one of her physician’s would have told me how my
decision could impact her today because I would have changed my
mind. As soon as she is off of her Prednisone I will have all three
of them in the pediatrician’s office!!!! I have talked to a few
mom’s to let them know how important the Varicella vaccine
Becky Johnson says
I’m in my mid-30s now but I had an extremely bad case of
chicken pox as a child. I wasn’t hospitalized but my parents were
not big on taking us to the doctor so who knows if I should have
been. I was young but I distinctly remember the agony of it for
days on end. I have a one inch scar on my breast that I’ve learned
to preemptively explain after a doctor asked if it was from a
biopsy. Two of my other siblings got it a couple years later and it
was extremely mild. If they had had it first, my parents probably
would have been fine with intentionally exposing me never knowing
how bad it would be. And they would have felt terrible they
subjected their kid to that. Every kid is different and every
parent figures their kid will get a mild version and be fine. That
isn’t always the reality. Now that there is a vaccine for this
disease, I can’t fathom not taking advantage of it. Just take it
off the table as something to worry about. My niece is almost 3 and
we’ve all learned a ton about all these other childhood diseases
that people have barely heard of (us included) and their
complications…diseases that don’t have vaccines or any treatment
other than keeping her comfortable (if that is even possible).
Knowing that the likelihood of her getting chicken pox is almost
zero is a relief.
So I’m in my late 30’s, healthy, and had chicken pox as a child. Sure wish the vaccine existed because I have already had shingles! It was the last week of my finals while finishing up my masters. A miserable experience. I don’t understand parents who want this for their children. All it takes is some good old fashioned stress and misery is all yours for those of us that have it sitting dormant in our bodies. And to think, that probably wasn’t my last bout with shingles…
Wendy Sue Swanson, MD, MBE says
On Facebook one commented this:
“I was just reading a study that said there is a rise of adult shingles because less children get the pox, therefore less adults gets that little immunity boost that warded off shingles later in life.
How many children get secondary infection or symptoms from the vaccination?
Can you send a study link?
I’m being sincere. I’m a Seattle parent, and the MMR shot is not reassuring to me.”
Wendy Sue Swanson, MD, MBE says
I talked with Dr Paul Offit, a vaccine expert and chief of pediatric infectious diseases at CHOP (in Philadelphia).
Like me he hadn’t hear of this study but he suggests this theory makes plenty of biologic sense but is all the more reason to get the Varicella vaccine. The vaccine is doing the same thing–stimulating and boosting immunity.
Dr Offit says:
“Circulation of wild-type varicella vaccine no doubt continues to boost immunity in those previously infected and could delay or eliminate progression to shingles. But, if anything, this should make people want to give their children the varicella vaccine all the more.
When the varicella vaccine came out in 1995, my son was 3 years old and attending a pre-school in which there was an outbreak of varicella. I couldn’t wait to get him the vaccine. Not because I thought he would likely suffer hospitalization or worse from varicella, but because I would much rather have the highly attenuated strain living latently in his nervous system (instead of the wild type strain). Many studies have clearly shown that although the attenuated strain can reactivate and cause shingles, it does so far less frequently and less severely.”
Melanie Silverman says
I am continually impressed by your blogs and the messages you send. THANK YOU for well thought out medical advice. (I try to do the same in pediatric nutrition).
I’m on the fence on this one. I was born in a developing country and have had family members who were injured by or died from the major disease we immunize against. Also, I’ve had the smallpox vaccine, TB, and everything my kids would get and lived to tell about it. So in that regard, I didn’t want to tangle with mumps or pertussis or even Hib. And, judging by my experience, I only stood to benefit as one of the on,u vaccinated individuals in my generation. Not wanting my kids to be less protected than me helped me overcome hesitancy when they had undesirable reactions (like very high fevers). By that same token, there isthe other hand…I had chickenpox – twice! It was a bigger deal the second time but no big deal overall. It was less miseable than the flu, and the flu is my minimum bar for vaccinating my kids. I really wasnt concerned with them getting it. My friends who live in some western European countries don’t even have ready access to the vaccine at the same ages we do, and it’s not pushed with as much urgency. Their same-age kids got chicken pox and were find. I didn’t get this vaccine until my kids each reached age 4 and we had to get ready for school. My kids’ pediatrician explained that my school-aged child would miss up to 3 weeks of school when you add up illness and quarantine. Loss of instruction time for individual students and productivity for schools when there is an outbreak is a significant factor – IMO – for vaccinating your kid for an illness they probably will weather just fine.
BTW my daughter as exposed, ironically, 1 week after her vaccination and didnt get it. My son was exposed prior to vaccination (granted he didn’t touch the other child, as the child’s mom intercepted) and didn’t get it, either.
Any ideas what causes shingles to pop up? I’ve been in some extremely stressful situations and haven’t had it. My sister didnt get it on chemo, which is pretty stressed and immuno-compramized.
Chris Johnson says
I’ve practiced pediatric intensive care (critical care)
medicine for thirty years. Over that time I have seen several
deaths from chickenpox in previously normal children. Besides the
virus itself, secondary infection of the sores with bacteria is not
uncommon. Get the vaccine
Amy Carney says
As a mom of vaccinated kids, I am struggling to find information about whether my kids should be around kids with chicken pox. Some time ago I read that vaccinated kids’ immunity can benefit from exposure to the wild type of the virus, but that doesn’t necessarily translate to ‘don’t cancel the playdate’ when the other kids have chickenpox. Any advice?
I have a daughter born 7/23/07. She had both vaccinations for chicken pox. A year after her last vacination she developed a blistery rash on her leg. When taken to the doc they said “it looks like shingles but it cant be becuase she has never had the chicken pox” Now here we are 8 months later and she has the rash again. In the same spot. When i took her back to the doctor this time they again said it looks like shingles. This time they reconized that children who have had the chickenpox vaccine can get shingles. Although rare and even more rare that she has had suspected shingles 2x. This time they took a culture for bactiria and for virus. It has been the longest week of my life waiting for the results to come back. If it is shingles and she has had it twice and is only 5 years old what is it saying about her immune system? anyone with any insight on this it would be appriciated.
Terri Coop says
I am late to this party, but it is a superb article, way more cogent and thoughtful than all the anti-vax spew.
My parents told the story of caring for me as an infant when I contracted chickenpox at just a few weeks old. This was the 1960s. Can you imagine the stress and anxiety of an infant with the itching biting rash and high fever – 24/7 for days? I nearly died of exhaustion and dehydration from the fever.
Mom was the biggest vaxxer ever. The minute it was approved, it was in my arm. But, my parents were not big on pediatricians. Kids’ illnesses were monitored and treated pallatively. Fevers were allowed to run their course with only comfort care. Very very few antibiotics. As a result, I have a pretty sturdy immune system and am very rarely ill. When I am, I am super sensitive to antibiotics and the big cheap crumbly horse pills are like chemo to me. Burns it all out. I wish my mom was still around to knock some sense into these loons.
Hundreds of deaths? According to the CDC:
Chickenpox used to be very common in the United States. In the early 1990s, an average of 4 million people got varicella, 10,500 to 13,000 were hospitalized (range, 8,000 to 18,000), and 100 to 150 died each year. In the 1990s, the highest rate of varicella was reported in preschool-aged children.
I don’t think I can trust anyone who quotes Dr. Paul Profit… I mean Offit.
My daughter got 2 cicken pox vaccination and still got full blown chicken poxs
Crazy people. I got the disease as a child and found out this year that my titer was negative, even after the disease. I just went through the full round of vaccines as I got a job in healthcare. I got titers for all of the other vaccine-preventable illnesses, and I have immunity for all of *them*.
I have a question though: Why did they still have me do TB tests if I had the BCG vaccine as a baby (I was born in eastern Europe)?
Wendy Sue Swanson, MD, MBE says
Many people with a history of BCG immunization will still get a PPD test (skin test) for TB screening. Here’s what the CDC says,
My daughter has been vaccinated twice for chicken pox (initial and booster) but the vaccine was not around when I was a kid (I had it….twice!). Now as an adult, I develop shingles on various parts of my body (usually around the middle or the butt, but this week, it’s on my forearm). My question is: since my daughter has been vaccinated, it is possible for me to transmit the virus through the shingle blisters to her, if she should touch them? As I said, it’s now on my forearm and I want to make sure she doesn’t come close to it. I wouldn’t wish this on my worst enemy; I can’t believe people deliberately expose their children to this future of misery.
pediatric oncall says
Yeah it’s amazing article but Varicella vaccine was developed in Japan in the early 1970s as a method to forestall varicella primary infection with varicella-zoster virus (VZV) in healthy and immunocompromised. it’s been shown to be bigger than 95% effective in protecting against severe sickness and 70% to 90% effective against gentle to moderate unwellness for kids 1 to 2 of years getting on for a minimum of 7 to 9 years once vaccination.
Trina Lee says
I am having a baby and have been trying to do some research about the vaccine. My problem is this…a few of my friends who have gotten the vaccine (2 shots) when they were younger have gotten chickenpox in their 20’s. One person miscarried, 2 were in ICU, and the others were hospitalized for various times. I would never introduce chickenpox to my child on purpose, but it easy to say vaccinate now and make sure to get a booster shot before becoming pregnant or be around someone with chickenpox when you are older, but so many times that is not an option. I grew up around the time the vaccine came out, but I had already had chickenpox from my 10 year old sister when I was a baby so I did not get it, but other friends I grew up with are running into problems like when their vaccinated kids get chickenpox and it is mild, but they get cases that are much worse. Once again a booster shot is supposed to help them, but by the time they knew their kids have chickenpox it was too late. So, tell what are we supposed to do about this situations? I am not anti-vaccinations and I believe vaccinations save lives, but no one is giving my a straight answer about how previous vaccinated adults deal with chickenpox exposure other than get a booster before becoming pregnant or be around someone with chickenpox.
Mark Rye says
I would suggest that anybody thinking of a pox party firstly google “chicken pox scars” and have a look at the images and articles of people wanting to remove them. they can be unsightly and really mess with self esteem.
Wendy Sue Swanson, MD, MBE says
Thanks for all the comments. As a reminder here is a policy for commenters. Happy to post comments that are respectful, not anonymous and on topic — even when opinions differ.
Jenny Lynn says
Didn’t read through all the replies. Because i can’t. In 1998 i was injured by a vaccine (Special Masters of The US Gov’t Vaccine Injury Compensation program agreed with all my doctors: neurologists, immunologists, and other specialists that this was indeed a legitimate vaccine injury and a very serious one at that, which triggered multiple autoimmune conditions.) i was ironically studying to be a doctor. As I was already working in a medical setting i got the heb B vaccine. And then my life as i knew it ended, as did all career aspirations and the ability even to parent my children.
Turns out i have one of the genes that is now identified with putting people at much higher risk for having a severe vaccine reaction. Turns out my children have it too. Their pediatricians have told me they absolutely should not get any vaccines unless it is life or death God forbid. So please don’t fall into the crowd that mindlessly recommends vaccines out of fear that pointing out the reality that some people are injured by them, some people greatly, (facts are clear that we don’t know the true number of how many people are injured by them) will cause some people not to vaccinate. First of all it’s lying. Second of all it takes away personal freedom, a crucial right that defines our nation. Yes, likely telling the truth about vaccines, that they have helped eradicate deadly diseases, and continue to protect many from diseases, but can cause injury to some who are susceptible, will cause parents to dig digger into the truth about them. And as a result indeed more children might not be vaccinated. But is this really going to be the public health crisis people who feel forced to lie about vaccine safety think it will be? i don’t think so. Has it been a health crisis for the populations who already don’t vaccinate? No, it hasn’t again thank God. I think what will happen is people will be screened for the genes that have an epigenetically higher likelihood of turning on and causing autoimmunity in the presence of a catalyst, which vaccines can be. Safer vaccines will be created, more at risk children will be protected, alternatives will be invented, and it will be a win win for all. In the long run more parents will feel comfortable vaccinating because they won’t be forced to distrust the CDC, the AMA, and the talking heads of Big Pharm.
There is a public health crisis transpiring right now. Our children are in big trouble. The autism rate is just one of the many rates of childhood disorders that have skyrocketed in the last few decades. Vaccines do have a role in it. But because of all the cover ups and lies, we con’t know the truth about how big OR small the role that they play is. We won’t know until we all face the facts on every level about how we are screwing up our bodies and our children’s bodies. Toxins in the environment, wireless frequencies causing calcium ion leakage in the neurons of all of us but much more potently in children thus exponentially increasing the adverse effect toxins have on the brain (who even knows about this? Am i about to be called a radical freak for stating that this very real phenomenon is happening and virtually no one wants to talk about it because cell phones and WiFi are really really awesome) various aspects of vaccines including the toxic ingredients but also the very manner in which they work, by ramping up the immune system, causing in some diseases of a too ramped up immune system, the lack of time outside, in the sun, moving our bodies in natural environments, the standard American diet, etc., and the interplay of all of these factors is obfuscated at the most foundational level because as a nation, as industries, as medical professionals, the people who should be seriously looking into it, seriously studying what the reality is, and telling us the serious truth: that we don’t actually know the truth and the reality, that major industries are more concerned with pushing superficial platforms to give vaccines a white washing they don’t deserve than either telling or even uncovering the truth as it is seen as a short term business loss. But it just isn’t that simple. It is not a black and white.
Denigrating parents who are not comfortable vaccinating their children, for very good, very scientifically proven, reasons does nothing but make them angry and pushed to the fringes of society: the place where most deep thinkers end up as well as bonafide lunatics. Studies coming out of Europe as well as in America show what about children raised in an Anthroposophic manner? You know those parents who send their children to Waldorf schools, force their kids to play outside instead of having access to tvs and video games, who don’t vaccinate and have chicken pox parties instead? They are, in every study i’ve seen, healthier in every single way. Personal happiness. Physical vitality. Longterm success in school and careers. While the mainstream is castigating them, telling them they are evil for their dangerous lifestyle choices, their children are thriving. And what they have been telling us for years about how to live and what to eat is slowly making it’s way into mainstream press as, well, the way to good health. i wish i could be like them, could have afforded to send my children to a Waldorf school, could have provided for them a lifestyle built on spending maximum time outdoors, active and eating homemade healthy food. But i haven’t been able to do that. Because i have only a couple of OK hours a day where i can get a little bit done, but not much, and can be a little active, meaning maybe do some of the dishes, and maybe on a really really good day take at the most a one minute walk with them. Because i was injured by a vaccine which almost ended my life completely, and left me a prisoner of the extreme limits of my new vaccine injured body. Overnight i went from extended backpacking, summiting high peaks with ease and bike riding 30 miles a day to being bed ridden most of the time, in and out of a wheel chair, 11 reconstruction surgeries to repair the damage done to my body by the autoimmune diseases the vaccine initiated and to facing each day like a war i have to win: the prize? Being able to shut my brain off at the end of the day to stop the pain and anguish of being in this post-vaccine body. The point of all of this? i guess just that you have compassion, empathy, and understanding why it is that for some chicken pox parties make the most sense.
Joan Horton says
You guys are talking about chickenpox but all of your doctor friends are commenting about measles. Why is that? And why would you include those comments. Yes people died of varicella pneumonia, but you don’t get varicella pneumonia from a form of Herpes. How does that work? Are you trying to scare people on purpose? Does anybody actually die of chickenpox? These are artists questions so don’t come at me.
While we’re at it, I’m vaccinated all my kids for chicken pox, and one of them ended up getting it when he was about 15. From what I’ve seen and heard that’s very common. So why are you saying that it gives you 99% Community? I think that might not be the correct statistic. Chickenpox is definitely not V most effective vaccine on the planet.
While we’re at it also? I just had a member of my extended family whose family did not vaccinate him get vaccinated and get measles. Perfectly healthy 22 year old. Can you explain that?