Tag: quarantine signs

Quarantines for Vaccine Preventable Diseases

The “quarantine of susceptible contacts without presumptive evidence of immunity” is a key tool that health experts use to control outbreaks of vaccine-preventable diseases.

Quarantines were routine in the pre-vaccine era.
Quarantines were routine in the pre-vaccine era.

Once upon a time, it was the only tool.

Quarantines for Vaccine Preventable Diseases

Some examples of quarantine periods include:

In addition to susceptible contacts, during an outbreak, even those who aren’t contacts are sometimes put under quarantine, or at least restricted from going to school.

At least they are if they aren’t naturally immune or haven’t been vaccinated. This is especially common during outbreaks of measles or chicken pox, in which case the quarantine may last much longer than 21 days.

In general, unvaccinated kids will have to stay out of school for at least 21 days after the last case could have been contagious and exposed others.

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Chicken Pox Parties

Tragically, that some folks still host and go to chicken pox parties is not a myth.

History of Chicken Pox Parties

In the pre-vaccine era, chicken pox parties made some sense.

A chickenpox quarantine sign

Since getting chicken pox was inevitable, you wanted your kids to get it when they were young.

That might help avoid some of the more serious complications of getting chicken pox as an adult.

Chicken Pox Parties

But now, with a safe and effective chicken pox vaccine, there is no good reason that kids should have to get chicken pox.

Getting chicken pox on purpose at a chicken pox party or from a chicken pox contaminated lollipop (welcome to the 21st century) that you ordered on the internet puts your child at risk with no extra benefit.

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Incubation Period of Diseases

Can’t you just stay home if you are sick with a vaccine-preventable disease and avoid getting others sick?

Once upon a time, with no treatment or vaccine, families would just be quarantined when they had chicken pox.
Once upon a time, with no treatment or vaccine, families would just be quarantined when they were sick. Photo by Howard Liberman.

That’s a common argument used by those who skip or delay one or more vaccines. They figure they aren’t putting anyone else at risk, because they will just keep their sick kid home.

Incubation Period of Diseases

The problem with that idea is that the incubation period for some diseases is very long.

The incubation period is defined as:

The time from contact with infectious agents (bacteria or viruses) to onset of disease.

And even more importantly, with some diseases, like measles and chicken pox, you can be contagious for several days even before you begin to show classic symptoms and know you are sick.

So you might take your intentionally unvaccinated child to a chicken pox party, planning to keep him away from others once he gets sick, not realizing that:

  • the incubation period for chicken pox is 10 to 21 days, meaning that it can take 10 to 21 days for you to get sick after being exposed to someone with chicken pox or shingles
  • you can be contagious to others one to two days before you even develop the classic chicken pox rash

While that might not be too big a deal if everyone around you is completely vaccinated, if any contacts are too young to have had two doses of the chicken pox vaccine, can’t be vaccinated because they have an immune system problem, or had their immunity wear off because of an immune system problem, then they could get sick.

That’s why the incubation period often turns into the quarantine period for most vaccine-preventable diseases.

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Shedding and Vaccines

Unlike many other myths about vaccines, shedding is a real thing.

It is just much, much less common than it is made out to be.

And it is very rarely something to be concerned about.

There is especially no research to suggest that children who were recently vaccinated, except in rare and very specific circumstances, need to be kept away from others to keep them from getting sick.

Kids get quarantined when they have a vaccine-preventable disease, not when they get their vaccines because we are concerned about shedding..
Kids get quarantined when they have a vaccine-preventable disease, not when they get their vaccines because we are concerned about shedding.

And definitely no reason to listen to the advice of one anti-vaccine organization who calls for “a two-week quarantine of all children and adults who receive vaccinations.”

Shedding and Vaccines

So what is shedding?

Shedding occurs when an infectious agent, typically a virus, can be found in urine, stool, and other bodily secretions. Shedding is not specific to vaccines though. Shedding occurs very commonly after natural infections too, which is one reason they are so hard to control.

Shedding is rarely an issue with vaccines though.

In fact, most vaccines are inactivated and don’t shed, including DTaP, hepatitis A, hepatitis B, Hib, flu, IPV, HPV, meningococcal, pneumococcal, and Tdap shots.

Also, except for the oral polio vaccine, which is no longer used in the United States, even close contacts of people with immune system problems can get “standard vaccines because viral shedding is unlikely and these pose little risk of infection to a subject with compromised immunity.”

The only circumstance where a live vaccine would be restricted because of theoretical concerns over shedding is for FluMist and close contacts of a severely immunocompromised patient who is in a protective environment (like after getting a stem cell transplant).

Other standard, live vaccines that might possibly shed are the chicken pox, MMR, and rotavirus vaccines.

The rotavirus vaccine only sheds in stool though, so routine hygiene techniques during diaper changes can prevent you from getting sick after your child gets this vaccine. We definitely aren’t seeing outbreaks of rotavirus triggered by shedding, so this likely works. Rotavirus infections are down significantly since we started routine vaccinations.

Chicken pox is also down significantly since we started vaccinating. There are no outbreaks because of shedding, which can occur, but only if the vaccinated person first develops a rash. Keep in mind that there are only a handful of reports that this has ever happened and if you did get sick, you would get the attenuated strain of chicken pox, not the more serious wild strain.

And what about the MMR vaccine. Although it is thought that rubella may shed into breastmilk after getting vaccinated, getting measles would be unheard of. Again, cases of measles are way down in the post-vaccine era.

The vaccinated are not spreading measles, chicken pox, or any other vaccine-preventable disease.

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