Tag: chicken pox deaths

Have Normal Childhood Diseases Become More Deadly?

Weren’t measles and chicken pox once a rite of passage for kids?

Yes, in the pre-vaccine era, almost all kids got measles, chicken pox, and other now vaccine-preventable diseases in early childhood.

It was considered a rite of passage.

That she doesn't understand survivorship bias doesn't mean that you shouldn't vaccinate your kids.
That she doesn’t understand survivorship bias doesn’t mean that you shouldn’t vaccinate your kids.

But these diseases were never benign.

They were considered a rite of passage only because we all had to endure them. They weren’t something anyone looked forward to.

Benign diseases don't kill kids.
Benign diseases don’t kill kids.

After all, you don’t typically die from a benign disease.

Have Normal Childhood Diseases Become More Deadly?

But what about the idea that folks never used to worry about these diseases, at least not until vaccines were developed? Or that we only fear diseases that are vaccine-preventable?

It’s easy to say that no one worried about measles in the pre-vaccine era when you are just trying to scare folks away from getting vaccinated.

That’s one of the more ridiculous arguments anti-vaccine folks make.

A measles epidemic hit New York City in 1951, as this front page NYTimes article reports.
A measles epidemic hit New York City in 1951 and made headlines in the New York Times. That’s not surprising, as there were 683 measles deaths in the United States that year.

And also one of the easiest to refute.

When was the last time that you saw a headline warning about congenital rubella syndrome?
When was the last time that you saw a headline warning about congenital rubella syndrome?

These diseases that are now vaccine-preventable routinely made headlines in the pre-vaccine era.

Even the schools were closed in San Antonio when polio came to Texas in 1946.
Even the schools were closed in San Antonio when polio came to Texas in 1946.

And it was surviving these diseases that was considered a rite of passage, at least for those who were fortunate enough to survive.

So no, childhood diseases have not become deadlier.

They have always been serious and life-threatening!

Of course, not everyone died who got them, but they were rarely a walk in the park. Remember, even a mild case of measles includes a high fever for 4 to 7 days. That’s why folks often end up seeking medical attention multiple times, even if they don’t end up having any complications and don’t need to get admitted to the hospital

Lassie got shot, but ended up saving the day, getting help for Timmy, after they ran out of gas taking a short cut rushing home.
The Lassie episode about measles, in 1958, was called ‘The Crisis.” There were 552 measles deaths in the United States that year.

But what about the Brady Bunch measles episode, Is There a Doctor in the House? Is that really why you think vaccine-preventable diseases are mild?

In 1969, when that episode first aired, there were 25,826 reported cases and 41 deaths from measles in the United States.

Why don’t we see that many deaths now?

That’s easy.

We don’t see as much measles now. Most folks are vaccinated and protected.

If more people skip or delay their vaccines though, we will see more and more outbreaks, with greater chances that people will die.

Believe it or not, we still don’t have cures for measles, chicken pox, congenital rubella syndrome, and hepatitis B, etc. So while these diseases haven’t become any more deadly, they haven’t become any less deadly either, even with all of the advances of modern medicine.

More on Childhood Diseases as a Rite of Passage

Is My Fully Vaccinated Child at Risk from Your Unvaccinated Kids?

Parents who skip or delay their own child’s vaccines often seem surprised that the rest of us are so concerned about their decision.

If vaccines work, they say, why do we care if their kids aren’t vaccinated?

Vaccines are protecting our kids, so they shouldn’t be at risk, right?

“Think of camping as an analogy. If everyone at a campground properly stores their food, bears won’t be enticed to come around. If even one person leaves their food unprotected, it invites bears in to investigate all the campsites for opportunities to eat.”

How does choosing not to immunize affect the community?

Of course, the issue isn’t just the risk to our fully vaccinated kids, but also the risk to those who are too young to be vaccinated, too young to be fully vaccinated, and those who can’t be vaccinated because of true medical contraindications.

In addition to those who are intentionally unvaccinated, these others often get caught up in outbreaks of vaccine-preventable diseases.

Is My Fully Vaccinated Child at Risk from Your Unvaccinated Kids?

But there is also a risk to those who are fully vaccinated, and no, that doesn’t mean that vaccines don’t work.

It just means that they don’t work 100% of the time.

And most of us don’t think that your vaccine choice should put our kids at extra risk.

Anti-vaccine propaganda pushes some folks to make bad decisions about vaccines.
Anti-vaccine propaganda pushes some folks to make bad decisions about vaccines.

Did you hear about the one measles outbreak in 2011 that was started by someone who was fully vaccinated?

“She had documentation of receipt of MMR vaccination at 3 years and 4 years of age. There was no travel during the incubation period and no known sick contacts. However, the index patient worked at a theater frequented by tourists.”

Outbreak of Measles Among Persons With Prior Evidence of Immunity, New York City, 2011

The thing about that outbreak, is that of the 222 cases that year, she was the only one known to be vaccinated. So she was almost certainly exposed to measles by someone who wasn’t vaccinated.

As someone who was fully vaccinated, is it fair that she got caught up in those outbreaks?

It is especially unfair that our kids are at extra risk for vaccine-preventable diseases because some folks make a decision to leave their kids unvaccinated and unprotected because they believe anti-vaccine misinformation like:

  • you have nothing to worry about because your child is vaccinated – again, vaccines aren’t 100% effective, so there is still some risk until a disease is finally eradicated
  • someone who is vaccinated could also get your child sick – yes, but someone who is vaccinated would be less likely to get sick than someone who is unvaccinated
  • vaccinated kids are shedding virus, making everyone sick – no, they aren’t, not even during “shedding season
  • getting vaccinated doesn’t prevent disease, it just makes it so you have fewer symptoms, but you still get others sick – in most cases, vaccines keep you from getting sick altogether – they so prevent disease in most cases, but yes, if you still got sick, you will likely have milder symptoms than if you were completely unvaccinated
  • you can’t spread a disease you don’t have – that’s true, but if you are unvaccinated and unprotected, you are at much higher risk to get these diseases and then spread them to others
  • vaccines don’t prevent diseases from spreading anyway – if you don’t get a disease because you are vaccinated, you aren’t going to spread it
  • getting vaccinated just turns you into a carrier – this is about the study in baboons, but it doesn’t mean you shouldn’t get vaccinated

What about the idea that you will just keep your unvaccinated kids home if they do catch something?

What are the chances that you could be exposed to measles during an outbreak?
What are the chances that you could be exposed to measles during an outbreak?

Looking at all of the places that the folks in the Clark County measles outbreak exposed others, it should be clear that waiting to quarantine your child if they get sick isn’t very effective.

What’s the problem?

An infant with measles during the 2014 outbreaks in the Philippines.
An infant with measles during the 2014 outbreaks in the Philippines. Photo by Jim Goodson, M.P.H.

With many diseases, you are contagious before you show symptoms. That is especially true with a disease like measles, when you may not even realize it is measles until you finally break out in a rash, after having 3 to 5 days of high fever.

That’s why it is important to vaccinate and protect your kids. When you skip or delay a vaccine, it is not just your own family that you are putting at risk.

More on Risks from Unvaccinated Kids

People with Cancer Are at Risk from Unvaccinated Kids

We know that kids with cancer aren’t at risk from shedding if someone has recently been vaccinated.

Johns Hopkins Medicine, which includes the Johns Hopkins University School of Medicine and The Johns Hopkins Hospital and Health System went out of their way to correct this anti-vaccine misinformation.
Johns Hopkins Medicine, which includes the Johns Hopkins University School of Medicine and The Johns Hopkins Hospital and Health System went out of their way to correct this anti-vaccine misinformation.

The real risk comes from those who are unvaccinated.

People with Cancer Are at Risk from Unvaccinated Kids

Confused on how that works?

Kids with cancer typically have a compromised immune system, so are at greater risk for getting sick and catching infectious diseases. This includes a risk from vaccine-preventable diseases because they often can’t be vaccinated and any vaccines they had in the past might no longer provide protection.

Don’t believe me?

Want some examples?

  • a 6-year-old girl who was in remission for ALL and had just received her final dose of chemotherapy was admitted with fever and neutropenia, found to have measles, and died after 28 days of intense therapy (1989)
  • an 8-year-old being treated for leukemia developed chicken pox and died two weeks later (1998)
  • a partially vaccinated 4-year-old girl who was being treated for acute lymphoblastic leukemia (ALL) was exposed to a cousin with chicken pox and later developed multi-organ failure and died (2012)
  • a 26-year-old man who was being treated for chronic lymphocytic leukemia died in Switzerland after he became infected with measles (2017)
  • a 6-year-old boy with leukemia died in Italy after catching measles from his intentionally unvaccinated sibling (2017)

Of course, there are many more, including many kids with cancer who get exposed to a vaccine-preventable disease and have to get treated with immunoglobulin and hope they don’t get sick. And many more who do get sick and are treated in the hospital for weeks and months and thankfully, get better.

And there are even more who get caught up in quarantines because they have true medical contraindications to getting vaccinated, and so have to stay home from school with the intentionally unvaccinated kids whenever there is an outbreak of measles or chicken pox, etc.

What can we do about this?

Vaccinate our kids! We have a choice. These kids with cancer don’t.

More on People with Cancer at Risk from Unvaccinated Kids

Making Sense of Anti-Vaccine Arguments

Have you ever tried to understand or make sense out of the things anti-vaccine folks say?

How did it go?

Making Sense of Anti-Vaccine Arguments

Consider what a group of anti-vaccine folks did with the above post about a child with severe complications to a chicken pox infection…

It's always a vaccine injury...
It’s always a vaccine injury…

What are some of the big complications of chicken pox infections? Complications that help make chicken pox deadly?

That’s right, secondary skin and soft tissue bacterial infections (cellulitis and necrotizing fasciitis). In fact, bacterial super-infections of the skin are the most common complication of chicken pox infections.

“Necrotizing fasciitis can lead to sepsis, shock, and organ failure. It can also result in life-long complications from loss of limbs or severe scarring due to surgically removing infected tissue. Even with treatment, up to 1 in 3 people with necrotizing fasciitis die from the infection.”

Necrotizing Fasciitis: All You Need to Know

No, chicken pox is not necrotizing fasciitis, but all of the breaks in the skin from chicken pox lesions give bacteria, including group A Streptococcus (group A strep) and Staphylococcus aureus, plenty of opportunities to enter a child’s body and quickly spread.

No one in the Netherlands dies with chicken pox???
No one in the Netherlands dies with chicken pox???

We often hear that chicken pox isn’t serious in other countries that don’t routinely use the chicken pox vaccine. Don’t believe them.

On average, about two young children die in the Netherlands each year due to chicken pox.

“Based on the results presented in this study we estimate that between 3 to 8% of all Dutch patients with varicella, depending on age, consult a GP due to a complication. Our findings are similar to data from Germany, France and the United States of America, were it is estimated that in approximately 2 to 6% of cases attending a general practice. Furthermore of these varicella patients 1.7% experiences complications severe enough to seek hospital care.”

Pierik et al on Epidemiological characteristics and societal burden of varicella zoster virus in the Netherlands

And folks in the Netherlands have similar rates of complications as we did in the United States in the pre-vaccine era and many are hospitalized.

Do you understand what’s happening in these comments? When folks choose to skip or delay their child’s vaccines, they will work hard to justify their decision.

Escaping cognitive dissonance explains a lot of anti-vaccine arguments.
Escaping cognitive dissonance explains a lot of anti-vaccine arguments.

That’s not surprising.

“the state of having inconsistent thoughts, beliefs, or attitudes, especially as relating to behavioral decisions and attitude change.”

cognitive dissonance definition

If you aren’t going to vaccinate your kids, do you want to think that you are leaving them at risk for such a serious complication, even if it is rare, or will you make up reasons for why the story can’t possibly be true?

Now these folks become skeptics?
Now these folks become skeptics?

Sure, these folks believe every vaccine injury story on Facebook without any proof, but all of a sudden they all become skeptics when faced with a story highlighting the known complications of a vaccine-preventable disease.

That’s the modern anti-vaccine movement.

More on Making Sense of Anti-Vaccine Arguments

Ethics and Vaccines

A lot of ethical issues come up around discussions of vaccines and vaccination.

Of course, when you talk about ethics and vaccines, you shouldn’t just think about vaccine mandates and informed consent, but also about the ethics of skipping or delaying vaccines and putting others at risk of getting a vaccine-preventable disease.

And there are also ethical issues around spreading misinformation and propaganda about vaccines (misinformed consent) to scare people away from getting vaccinated and protected.

Ethics and Vaccines

Does it surprise you that many folks don’t actually understand what the real ethical issues are in the “vaccine debate?”

Questions about ethics often come up when Dr. Bob talks about vaccines.
Questions about ethics often come up when Dr. Bob talks about vaccines.

To begin with, there is no real vaccine debate.

Vaccines are safe, effective, and necessary.

“But how can anything with known side effects be forced, knowing some will definitely be harmed?”

Dr. Bob Sears

Dr. Bob’s statement helps illustrate why this isn’t a debate.

No one is forced to get vaccinated.

And how can you say that “some will definitely be harmed” without defining what some actually means?

Severe reactions to vaccines are very rare. Fortunately, they are even more rare than the risks of a complication from a vaccine-preventable disease. And that’s why the great majority of people choose (they aren’t forced) to vaccinate and protect their kids.

Remember, a vaccine mandate that says you have to be vaccinated to attend daycare or school does not force anyone to get vaccinated. Folks still have a choice to not get vaccinated, even without access to non-medical vaccine exemptions, although they might not like what that choice entails, such as homeschooling or not being able to attend daycare or summer camp.

What about the idea of community responsibility?

Should you vaccinate your child just to protect everyone else in the community or should you just try to hide in the herd?

“One is morally free to use the vaccine regardless of its historical association with abortion. The reason is that the risk to public health, if one chooses not to vaccinate, outweighs the legitimate concern about the origins of the vaccine. This is especially important for parents, who have a moral obligation to protect the life and health of their children and those around them.”

The National Catholic Bioethics Center FAQ on the Use of Vaccines

Of course you should vaccinate them. But in getting them vaccinated and protected, you are not just protecting everyone else in the community. Getting vaccinated also protects your own child!

Similarly, when you skip or delay your child’s vaccines, it is not just your own child that is put at risk. If they get sick, especially since many vaccine-preventable diseases have long incubation periods and you can be contagious before you show symptoms, they can expose others and get them sick too. Where’s their choice?

If the people they expose are too young to be vaccinated, too young to be fully vaccinated and protected, or anyone with a problem with their immune system, the results can be tragic.

Is it ethical that someone decides to skip or delay their child’s vaccines and then, through no fault of their own, someone else dies after getting exposed to this unvaccinated child when they develop measles or chicken pox?

Remember the measles outbreaks of 2015? In addition to the large Disney Land measles outbreak, 2015 was infamous for a smaller outbreak in Clallam County.

“The death of a Clallam County woman this spring was due to an undetected measles infection that was discovered at autopsy. The woman was most likely exposed to measles at a local medical facility during a recent outbreak in Clallam County. She was there at the same time as a person who later developed a rash and was contagious for measles. The woman had several other health conditions and was on medications that contributed to a suppressed immune system. She didn’t have some of the common symptoms of measles such as a rash, so the infection wasn’t discovered until after her death. The cause of death was pneumonia due to measles. This tragic situation illustrates the importance of immunizing as many people as possible to provide a high level of community protection against measles.”

Measles led to death of Clallam Co. woman

There were five measles cases in that 2015 Clallam County, Washington outbreak, including four who were not vaccinated. The outbreak cost at least $223,223 to contain and led to the death of a woman who just happened to be at a health clinic as one of the infected people.

Want to dismiss this case as being too rare to worry about? Just look at what is happening across Europe, with the rise in measles cases and measles deaths over the last few years.

Ethically, why should you vaccinate?

That’s easy, so that your kids don’t get a life-threatening vaccine-preventable disease. And so that they don’t expose others, potentially giving them a life-threatening disease that they are too young to be vaccinated against, couldn’t be vaccinated against because they had a true medical exemption, or were vaccinated against but are still susceptible to because they now have a problem with their immune system.

Are vaccine preventable diseases not common enough for you to be concerned about these days? You know that’s because most folks vaccinate their kids, don’t you? Do we need to go back to the pre-vaccine era before more vaccine-hesitant parents will start vaccinating their kids?

“I also warn them not to share their fears with their neighbors, because if too many people avoid the MMR, we’ll likely see the diseases increase significantly.”


Dr. Bob Sears in The Vaccine Book

What about the risks of vaccines?

While vaccines are not 100% safe, they do not cause all of the vaccine injuries and vaccine-induced diseases that anti-vaccine folks push. The real risk is believing their propaganda and leaving your child unvaccinated and unprotected.

“It is UNETHICAL to expect me to sacrifice my child for yours—especially when I know that sacrifice won’t even stop the disease from spreading. It’s time for people to stop touting their “moral superiority and selflessness” when it comes to this topic; because if you really understood how this all works, there would be nothing for you to be proud of.”

Melissa Floyd (she apparently does a podcast with Dr. Bob)

Here is where the misinformed consent comes in and ethics go out the window:

And for the record, few of us think that we are morally superior to anyone else for vaccinating and protecting our kids. We just understand that many anti-vaccine folks are victims of their cognitive biases and need to do more research. And we know that it is UNETHICAL for parents to sacrifice their kids to anti-vaccine propaganda.

More on Ethics and Vaccines

Can You Still Get Shingles After Having the Chicken Pox Vaccine?

It is very easy to get confused when thinking or talking about chicken pox and shingles.

Remembering a few things should help though:

  • shingles (herpes zoster) is a reactivation of chicken pox (varicella zoster) – since they are caused by the same virus, you had to have been exposed to the chicken pox virus (varicella zoster virus) to later get shingles
  • exposure to the chicken pox virus can come from a natural chicken pox infection or from getting vaccinated against chicken pox, as it is a live, attenuated vaccine (Varivax)

So no, getting the chicken pox vaccine will not prevent you from later getting shingles. The shingles vaccine is a different vaccine that is given to seniors to help prevent them from getting shingles.

Can You Still Get Shingles After Having the Chicken Pox Vaccine?

Have you ever heard of a child vaccinated against chicken pox getting shingles? It can happen. It’s not a vaccine injury.

Remember that you can get shingles at any age – it is not just a disease of senior citizens. Even preschools or teens can get shingles, with the risk increasing with age.

Although rare, even infants can develop shingles, most commonly if their mothers had a chicken pox infection while pregnant.
Although rare, even infants can develop shingles, most commonly if their mothers had a chicken pox infection while pregnant. Photo by Kaoutar Zinelabidine et al.

Although the chicken pox vaccine won’t prevent you from getting shingles, it does work well to prevent you from getting chicken pox.

And it is thought that getting vaccinated and protected against chicken pox will decrease your risk of later getting shingles, even before you ever get the shingles vaccine.

“In the early post-varicella vaccination period, incidence rates of medically attended herpes zoster did not increase for the overall population and decreased moderately for children 9 years and younger, the age group targeted for varicella vaccination.”

Tanuseputro et al on Population-based incidence of herpes zoster after introduction of a publicly funded varicella vaccination program

No chicken pox and a lower risk of shingles?

I’m glad my kids are fully vaccinated!

More on Shingles and the Chicken Pox Vaccine

Where Are the Latest Chickenpox Outbreaks?

Breaking News – 32 cases at a school in Northern Kentucky (see below)

Chicken pox is a now vaccine-preventable disease thanks to the chicken pox vaccine that was first licensed in 1995.

Despite being added to the childhood immunization schedule in 1996, and the addition of a booster dose in 2007, we do continue to see occasional outbreaks of chicken pox.

Chicken Pox

Although chicken pox is said to have been a rite of passage for kids, it was never something that any of us looked forward to.

At best, you had five to seven days of fever and an itchy rash that covered your body.

“My life changed forever on June 30, 1988, when I had to stand by helplessly as an infectious disease claimed the life of my oldest child, Christopher Aaron Chinnes, at the age of 12.”

Rebecca Cole on Chickenpox Claimed the Life of My Son Christopher

But of course, some people had much more severe cases of chicken pox and some people died.

Chicken Pox Outbreaks

In the pre-vaccine era, before the mid-1990s, most kids got chicken pox.

And chicken pox parties, while not as common as some folks imagine, were definitely a thing, because you didn’t want your child to become an adult and get chicken pox, when it was more dangerous. But since most kids got chicken pox so easily, most got it when they were kids, even without a chicken pox parties, and tragically, many learned that it wasn’t only dangerous to adults.

Why are we still seeing clusters of chicken pox in schools when a safe and effective vaccine is readily available?
Why are we still seeing clusters of chicken pox in schools when a safe and effective vaccine is readily available?

These days, most cases and outbreaks of chicken pox are in unvaccinated children and adults.

  • 32 cases at the Our Lady of the Sacred Heart and Assumption Academy in Walton, Kentucky leading to the quarantine of all unvaccinated students (March 2019)
  • 7 new cases in the outbreak associated with the Asheville Waldorf School in West Asheville, North Carolina, bringing the case count to 41 in that outbreak, including 4 cases in the community as the outbreak continues to spread (Nov 2018)
  • 6 new cases at the Asheville Waldorf School in West Asheville, North Carolina, bringing the case count to 34 in that outbreak (Nov 2018)
  • several students at Hoquiam High School in Hoquiam, Washington (Nov 2018)
  • at least 28 cases at Asheville Waldorf School in West Asheville, North Carolina (Nov 2018)
  • at least 5 cases at Daybreak Primary School in Battle Ground in Clark County, Washington, leading to quarantine of at least 38 unvaccinated students who will be kept out of class for at least 21 days (Oct 2018)
  • at least 5 cases at two schools in Ottawa County, Michigan, including Waukazoo Elementary and Kids First – Early Childhood Center in Jenison, leading to the quarantine of at least 34 children (Oct 2018)
  • a cluster of chicken pox cases in Grant County, Washington at Park Orchard Elementary, North Elementary and Longview Elementary schools (Sept 2018)
  • at least 5 cases at the The Little Red School House Too daycare in Westbrook, Maine (May 2016)

These cases are just the tip of the iceberg though, as there are still about 7,000 to 10,000 chickenpox cases reported in the United States each year. And that’s with some states, like Oregon and Washington, not reporting cases of this Nationally Notifiable Condition to the CDC.

Cognitive dissonance helps explain how these folks try to explain that chicken pox isn't dangerous.
Cognitive dissonance helps explain how these folks try to explain that chicken pox isn’t dangerous.

Still, since chicken pox caused a few hundred deaths and at least 10,000 hospitalizations each year less than twenty-five years ago, that’s a lot of progress.

Getting Chicken Pox

How do you get chicken pox?

Since it is very contagious, if your child is exposed to someone with chicken pox or shingles, then they might develop chicken pox in about 10 to 21 days (incubation period).

Of course, if they vaccinated and protected, then they probably won’t, although mild, breakthrough chicken pox infections are still possible in vaccinated kids.

Their risk is higher if they:

  • are unvaccinated, either intentionally, because they have a true medical exemption, or because they are too young for the vaccine, which is first given when kids are 12-months-old
  • are partially vaccinated, with only one dose of the chicken pox vaccine
  • have a problem with their immune system, including kids getting chemotherapy

In addition to being at risk for chicken pox, non-immune pregnant women, newborns born to women who develop chicken pox at around the time of delivery, premature babies, and those are immunocompromised can be at risk for severe disease.

Avoiding Chicken Pox

Want to avoid chicken pox and the chance of ending up in a chicken pox quarantine and having to stay out of school for 3 weeks or more?

Get your kids vaccinated.

That’s not an option for some kids with true medical exemptions though, including most kids who are immunocompromised. When they get caught up in one of these outbreaks and get exposed to chicken pox, it becomes a matter of life and death to work to try and prevent their getting chicken pox.

More on Chicken Pox Outbreaks

Updated on March 14, 2019