Tag: breakthrough chickenpox

About That Chickenpox Outbreak in New York

Anti-vax folks really seem to be excited about a new case of chickenpox at a school in New York.

There is a case of chickenpox at a school in New York.
Made my day?

A case that wasn’t report until after they implemented new rules that eliminated religious vaccine exemptions.

About That Chickenpox Outbreak in New York

So does this chickenpox pox case or outbreak in New York somehow mean that their plan isn’t working?

Of course not!

For one thing, it is only one case.

Remember that chickenpox outbreak in Kentucky last Spring? At least 32 kids ended up getting chickenpox!

That shouldn’t happen at this school in New York, as there hopefully aren’t even 32 unvaccinated kids left to get sick. There might be though…

Wait, how could there be 32 unvaccinated kids if they have eliminated non-medical exemptions?

Well, since the law just went into effect at the start of this school year, kids likely haven’t had time to get fully vaccinated.

Wait, what?

Children who are not fully immunized can continue to attend school if they are in the process of completing the ACIP catch-up schedule or if they are otherwise exempt from immunization requirements. A school shall not refuse to admit a child based on immunization requirements, if that child is “in process.”

New York School Immunization Q&A

Also, for some reason, “students entering grades 5, 11 and12 for the 2018-19 school year are only required to have received one dose of varicella vaccine.”

Remember, to be considered fully vaccinated against chickenpox, kids should have two doses of the chickenpox vaccine.

So it should be easy to see that there may be students in New York schools who are only partially vaccinated.

What else?

The deadline for kids to get vaccinated was September 17 and the vaccine takes at least two weeks to work.

The case was reported on October 18.

Add in the 10 to 21 day incubation period and it is very possible that this was a student who was initially unvaccinated and developed chickenpox before his vaccine had time to work!

Whaddya know!!

Are there any other possibilities?

Could it simply be a student with breakthrough chickenpox? A child who was vaccinated, but developed chickenpox anyway?

Sure.

While the chickenpox is said to be 100% effective at preventing severe cases of chickenpox, you can still sometimes get milder, breakthrough infections, even after two doses.

Or the case could be in a teacher or other school worker.

What about shedding?

While the chickenpox vaccine is said to rarely cause a rash, it typically occurs at the site of injection, so it is unlikely that it would be confused with a full blown case of chickenpox. And this rash rarely gets others sick.

The bottom line though is that with fewer fully unvaccinated students in school now, this is unlikely to develop into a big outbreak.

More on Chickenpox Outbreaks

Did Bobby Kennedy Admit That Chickenpox Kills People?

The usual talking point from folks who are anti-vax is that vaccine-preventable diseases are mild. Some even go so far to say that they are good for you! It isn’t too often that these folks admit that these diseases, from measles and polio to chickenpox, do indeed kill people.

Bobby Kennedy finally gets it right, admitting that chickenpox killed 100 people a year in the pre-vaccine era.
Having chickenpox doesn’t protect you from developing shingles – it’s why you develop shingles!

No, chickenpox doesn’t kill 1 in 100 people, but that doesn’t mean that people don’t die with chickenpox, especially if they are unvaccinated and unprotected.

Did Bobby Kennedy Admit That Chickenpox Kills People?

Do we want to go back to the days when more folks were dying with chickenpox?

“The total cost to theoretically save 50 children is approximately $900 million dollars or $17.5 million per life saved.”

Bobby Kennedy

What else does Bobby Kennedy say?

“Chickenpox can reactivate as shingles when an adult’s immunity wanes or is not boosted by periodic exposure to children with chickenpox. CDCs clinical studies predicted that widespread vaccination would double shingles rates among adults and children and precipitate a shingles epidemic. “

Bobby Kennedy

While it is true that chickenpox can reactivate as shingles, a bonus of getting vaccinated and protected with the chickenpox vaccine is that it actually decreases your risk of developing shingles later in life!

And those countries that didn’t vaccinate and protect their kids with the chickenpox vaccine, because they thought it might cause a later shingles epidemic if fewer kids were sick and boosting the immunity of adults who had already had chickenpox still saw a rise in shingles cases.

That’s probably why many of those countries are now considering adding the chickenpox vaccine to their schedule.

What else did Bobby Kennedy say?

“…chickenpox presents as a mild rash and slight fever and confers lifetime immunity to chickenpox and significant protection against shingles, heart disease, atopic diseases, and cancers including glioma, brain, and spinal tumors. “

Bobby Kennedy

The part about getting lifetime immunity to chickenpox is true.

Does chickenpox provide significant protection against heart disease, atopic disease, or cancer?

Nope.

And of course, if you have ever had chickenpox, you know that it is far more than “a mild rash and a slight fever.”

Unvaccinated kids with chickenpox typically have 250 to 500 blisters over their entire body.
Unvaccinated kids with chickenpox typically have 250 to 500 blisters over their entire body. Photo courtesy CDC/ Dr. John Noble, Jr..

In a routine case of chickenpox, the fever typically rises to at least 102°F and lasts for at least 2 to 3 days, with the rash persisting for up to a week.

Unfortunately, not all chickenpox cases are routine.

In addition to the deaths, there are plenty of reports of kids having complications with chickenpox and developing skin superinfections, pneumonia, encephalitis, or having strokes.

What else does Bobby Kennedy say?

“Merck’s vaccine is only 60% effective after 5 years, leaving adults vulnerable to shingles.”

Bobby Kennedy

Actually, it has been found that one dose of the chickenpox vaccine is 100% effective at preventing severe disease!

So why do we get two doses?

“This study confirmed that varicella vaccine is effective at preventing chicken pox, with no waning noted over a 14-year period. One dose provided excellent protection against moderate to severe disease, and most cases occurred shortly after the cohort was vaccinated. The study data also suggest that varicella vaccination may reduce the risks of HZ in vaccinated children.”

Baxter et al on Long-term effectiveness of varicella vaccine: a 14-Year, prospective cohort study.

Two doses of the chickenpox vaccine are up to 94% effective at preventing any chickenpox disease, even breakthrough cases.

And again, several studies have confirmed that getting vaccinated and protected with the chickenpox vaccine decreases your risk of developing shingles!

Do you really want your kids to be at risk to get chickenpox and have a higher risk to get shingles later in life?

Of course not. That’s why you hopefully don’t listen to folks like Bobby Kennedy and you vaccinate and protect your kids.

More on Chickenpox Deaths

Do Vaccinated Kids Who Get Sick Have Milder Disease?

There is another benefit of vaccines that you might not be aware of.

Vaccines are typically very effective, but of course, they aren’t perfect.

Fortunately, even when they don’t work and you do get sick, vaccinated kids will often have milder disease than those who are unvaccinated.

Do Vaccinated Kids Who Get Sick Have Milder Disease?

While no one expects to get a vaccine-preventable disease if they have been vaccinated, it is nice to know that often, you will at least have a milder disease.

“Disease may occur in previously vaccinated individuals. Such breakthroughs are either primary – due to vaccine failure – or secondary. In such cases, the disease is usually milder than in the non-vaccinated.”

Vaccination greatly reduces disease, disability, death and inequity worldwide

Milder mumps and pertussis?

“The number of previous vaccine doses was inversely associated with clinical severity.”

Zamir et al on Characteristics of a large mumps outbreak: Clinical severity, complications and association with vaccination status of mumps outbreak cases

Yes!

And that’s good news for all of the folks concerned about waning immunity with these vaccines.

“A protective effect of vaccination was noted when mean duration of symptoms and hospital stay are analysed, comparing unvaccinated, partially vaccinated and fully vaccinated children. We showed a vaccination dose effect trend, with fully vaccinated children having less-severe RVGE than not vaccinated and partially vaccinated children.”

Justino et al on Clinical Severity and Rotavirus Vaccination among Children Hospitalized for Acute Gastroenteritis in Belém, Northern Brazil

Consider that, in addition to preventing disease:

  • two doses of MMR has been found to have a significant preventive effect against mumps complications, including orchitis, meningitis, and encephalitis, and hospitalization for mumps
  • two doses of the chickenpox vaccine has been found to be very effective at preventing severe disease, in fact, kids with breakthrough chickenpox often don’t have fever, have fewer than 50 spots, and they go away quicker than kids who are unvaccinated.
  • vaccinated kids who get pertussis typically don’t cough as long as those who are unvaccinated
  • the rotavirus vaccine series, in addition to protecting most kids from getting rotavirus infections in the first place, protected all of the vaccinated kids from getting severe infections
  • the flu vaccine reduces the risk of severe disease, especially if you are hospitalized with the flu

What does this all mean?

Two kids with smallpox - one vaccinated and one unvaccinated. Can you guess which is which? The vaccinated child on the right only has one or two spots...
Two kids with smallpox – one vaccinated and one unvaccinated. Can you guess which is which? The vaccinated child on the right only has one or two spots…

It means that vaccines work, even when they don’t work as well as we would like them to!

More On the Severity of Breakthrough Infections

Varicella Vaccines

First licensed in the United States in 1995, the live, Varicella vaccine protects against chickenpox.

A booster dose was added to the immunization schedule in 2006, to help prevent breakthrough infections.

Now all children get their first dose of the Varicella vaccine when they are 12 to 15 months old, with a booster dose when they are four to six years old.

More on Varicella Vaccines