Tag: rashes

Believe It or Not, Chicken Pox Parties Are Still a Thing

Do you remember having chicken pox?

Oh boy, I sure do!

I was about six or seven years old and it was bad. Still, I’m not sure if I remember because I had such a bad case or because it made me miss Halloween that year.

It was almost certainly both, as I remember being covered in spots from head to toe.

What I don’t recall is having many visitors. Why didn’t my mom throw me a chicken pox party!

I also don’t remember going to a chicken pox party to get sick.

Believe It or Not, Chicken Pox Parties Are Still a Thing

Whether or not chicken pox parties were ever that popular, the approval of the chicken pox vaccine in 1995 should have put an end to the practice.

After all, why intentionally expose your child to a potentially life-threatening disease, when a safe and effective vaccine is readily available?

“Chickenpox (varicella) is generally a much milder illness in children than in adults, with considerably lower rates of severe disease and death. Varicella is also virtually universal in many populations, meaning that very few individuals escape infection over a lifetime. Thus, a sound logic underlies the idea of chickenpox parties, at which susceptible children can acquire the contagious causative pathogen, varicella zoster virus (VZV), from their peers. However, chickenpox is not without risks, even for children of this age; severe, complicated, and occasionally fatal varicella occur in previously healthy children, as well as the immunocompromised (who are at very considerable risk).”

Hambleton et al on Chickenpox Party or Varicella Vaccine?

Most folks understand that. They get their kids vaccinated and have helped get chicken pox under very good control, with outbreaks of chicken pox declining over 95%.

“Each year, more than 3.5 million cases of varicella, 9,000 hospitalizations, and 100 deaths are prevented by varicella vaccination in the United States”

CDC on Monitoring the Impact of Varicella Vaccination

Apparently, not everyone has gotten the message though.

Remember when CPS had to investigate the mom who was having chicken pox parties in Plano, Texas a few years ago?

“On the page, parents post where they live and ask if anyone with a child who has the chicken pox would be willing to send saliva, infected lollipops or clothing through the mail.”

CBS 5 Investigates mail order diseases

Or when anti-vaccine folks were selling and mailing lollipops contaminated with chicken pox to folks so that they could skip the trouble of finding a chicken pox party?

And then there’s that time that a family served chicken pox contaminated punch at their chicken pox party. Oh wait, that was The Simpsons…

Chicken pox party - The Simpsons did it.
Chicken pox party – The Simpsons did it in the Milhouse of Sand and Fog episode in Season 17.

So what are they up to now?

Folks are still advertising chicken pox parties in anti-vaccine Facebook groups.
Folks are still advertising chicken pox parties in anti-vaccine Facebook groups.

More of the same…

Does she know that the chicken pox vaccine likely decreases your risk of getting shingles later in life?
Does she know that the chicken pox vaccine likely decreases your risk of getting shingles later in life?

Apparently, there are still plenty of folks looking for chicken pox parties to infect their kids.

Why?

It is easy to see a lot of cognitive biases at play in the decision to host or bring a child to a chicken pox party, including ambiguity aversion (prefer what they think are the known risks of getting the disease), bandwagoning (they think everyone else is doing it, because in their echo chambers of anti-vaccine propaganda, everyone might), and optimism bias, etc.

There is also a very poor perception of risks, as the risks from a natural chicken pox infection are far, far greater than any risk from the vaccine.

Don't forget to tent!!!
Don’t forget to tent and share breath!!!

In bigger news, Facebook has groups who’s mission is “finding pox,” so that parents can get their kids sick!

The mission of PX Colorado is finding pox!
The mission of PX Colorado is finding pox!

How many other PoX type groups are there on Facebook?

How many other parents are intentionally not vaccinating their kids and intentionally exposing them to chicken pox?

Do any of them quarantine or isolate their kids for 10 to 21 days after the chicken pox party, so as to not expose anyone who is too young to be vaccinated, too young to be fully vaccinated, or has a true medical exemption to getting vaccinated, including those who are immunocompromised?

Do they understand the consequences of having these pox parties?

The latest chicken pox party hostess is apparently a nurse - at least for now...
The latest chicken pox party hostess is apparently a nurse – at least for now…

Of course, an investigation from CPS, the health department, or a medical board isn’t the most serious consequence that should discourage folks from hosting or attending a chicken pox party.

Chicken pox can be a serious, even life-threatening infection. Sure, many kids just get a mild case, but others get more serious cases and have bad complications, including skin infections, encephalitis, sepsis, or stroke.

And some people do still die from chicken pox, which is supposed to be a mild, childhood illness.

“This report describes a varicella death in an unvaccinated, previously healthy adolescent aged 15 years.”

Varicella Death of an Unvaccinated, Previously Healthy Adolescent — Ohio, 2009

Fortunately, these deaths have been nearly eliminated thanks to the chicken pox vaccine.

And that’s why parents who are on a mission for “finding pox” should rethink things and switch to a mission to get their kids vaccinated and protected.

More on Chicken Pox Parties

How Can the Unvaccinated Spread Diseases They Don’t Have?

Folks who are intentionally unvaccinated often have a hard time understanding why the rest of us might be a little leery of being around them.

That’s especially true if we have a new baby in the house, younger kids who aren’t fully vaccinated and protected, or anyone with a chronic medical condition who can’t be vaccinated.

Why? Of course, it is because we don’t want them to catch measles, pertussis, or other vaccine-preventable diseases.

“How can you spread a disease that you don’t even have?”

It’s true, you can’t spread a disease that you don’t have.

But infectious diseases don’t magically appear inside our bodies – we catch them from other people. And if you have skipped or delayed a vaccine, then you have a much higher chance of getting a vaccine-preventable disease than someone who is vaccinated and protected.

So, just avoid other people when you are sick, right?

“…the increased risk of disease in the pediatric population, in part because of increasing rates of vaccine refusal and in some circumstances more rapid loss of immunity, increases potential exposure of immunodeficient children.”

Medical Advisory Committee of the Immune Deficiency Foundation

That works great in theory, but since you are often contagious before you show signs and symptoms and know that you are sick, you can very easily spread a disease that you don’t even know that you have.

An infant hospitalized during a measles outbreak in the Philippines in which 110 people died.
Children with measles are contagious 4 days before through 4 days after their rash appears, but you often don’t recognize that it is measles until they get the rash! Photo by Jim Goodson, M.P.H.

There’s the trouble:

  1. being unvaccinated, you or your child are at higher risk to get sick
  2. when you get sick, you can be contagious several days before you have obvious symptoms
  3. you can spread the disease to others before you ever know that you are sick, or at least before you know that you have a vaccine preventable disease

This makes intentionally unvaccinated folks a risk to those who are too young to be vaccinated, are too young to be fully vaccinated, have a true medical exemption to getting vaccinated, or when their vaccine simply didn’t work.

measles-santa-clara-county
Folks with measles often expose a lot of other people because they don’t yet know that they have measles and aren’t showing signs and symptoms yet.

In fact, this is how most outbreaks start. Tragically, kids too young to be vaccinated get caught up in these outbreaks.

Keep in mind that these parents didn’t have a choice about getting them protected yet. Someone who decided to skip their own vaccines made that choice for them.

And remember that while you can’t spread a disease that you don’t even have, you can certainly spread a disease that you don’t realize that you have.

What to Know About The Unvaccinated Spreading Disease

If you aren’t going to get vaccinated or vaccinate your kids, understand the risks and responsibilities, so that you don’t spread a vaccine-preventable diseases to others that you might not even know that you have yet.

More on the Unvaccinated Spreading Disease

Can Vaccines Cause Eczema?

Eczema, or atopic dermatitis, can be hard to control.

That’s one of the things that is so frustrating about it.

It’s also often hard to figure out what exactly is triggering a child’s eczema. Is it the soap you are using, your child’s clothes, or something he eat or drank?

What Causes Kids to Have Eczema?

Another frustrating thing for parents, and pediatricians, is that we really don’t know what usually causes kids to have eczema in the first place.

Was it the soap you are using, your child’s clothes, or something he eat or drank?

“Research suggests that genes are the determining causes of eczema and other atopic diseases. This means that you are more likely to have atopic dermatitis, food allergies, asthma and/or hayfever if your parents or other family members have ever had eczema.”

Mark Boguniewicz, MD on What Causes Eczema

Unfortunately, simply knowing that eczema is genetic doesn’t make it any less frustrating for many people.

“There is emerging evidence that inflammation in atopic dermatitis is associated with immune-mediated and inherited abnormalities in the skin barrier.”

Amy Stanway, MD on Causes of atopic dermatitis

You can avoid likely triggers, including harsh soaps and dry skin, etc., and learn the best ways to care for your baby’s skin though.

Can Vaccines Cause Eczema?

Why do some folks associate vaccines with eczema?

“It is unusual for an infant to be affected with atopic dermatitis before the age of four months but they may suffer from infantile seborrhoeic dermatitis or other rashes prior to this.”

Amy Stanway, MD on Atopic Dermatitis

It’s easy to understand when you realize that 60% of kids with eczema have their first symptoms before their first birthday and for some, the first symptoms start around the time an infant is just over four months old.

Many baby rashes, especially if they started before 4 months, are probably not eczema.
Many baby rashes, especially if they started before 4 months, are probably not eczema. (CC BY-SA 2.0)

Did your baby have bad skin before four months?

Many do, but they usually don’t have eczema. In the first week or two, newborn rashes like infantile seborrheic dermatitis and neonatal acne continue to worsen, until they reach a peak at about age six weeks. It isn’t until about three or four months that baby’s begin to have good skin. Unless they start to develop eczema…

So, since the eczema symptoms start after a child’s four or six months shots, then it must be the vaccines, right?

While the correlation is obvious, that obviously doesn’t prove that vaccines cause eczema.

“Vaccinations do NOT cause eczema.”

Amy Paller, MD on Do vaccines cause eczema?

And, not surprisingly, several studies (listed below) prove that they don’t.

A large study of vaccinated vs unvaccinated children, Vaccination Status and Health in Children and Adolescents Findings of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), also found that “the prevalence of allergic diseases and non-specific infections in children and adolescents was not found to depend on vaccination status.”

Can Vaccine Ingredients Trigger Eczema?

Now that we know that vaccines don’t actually cause eczema, what about the idea that vaccines can make a child’s eczema worse?

That’s actually true, but only for the smallpox vaccine.

If someone with eczema gets vaccinated with vaccinia, the smallpox vaccine, or is recently exposed to someone who was vaccinated, they could develop eczema vaccinatum. Fortunately, since smallpox was eradicated, very few people get the smallpox vaccine anymore.

And back before smallpox was eradicated, they actually developed an attenuated version of the smallpox vaccine that could safely be used in kids with eczema!

Other vaccines are not thought to trigger or worsen eczema.

“Parents of atopic children should be encouraged to fully immunize their children.”

Grüber et al on Early atopic disease and early childhood immunization–is there a link?

While many kids with eczema do have food allergies and some vaccines do contain some residual food proteins, including eggs and milk, it is very rare for them to trigger food allergy reactions.

If this has you concerned, remember that even kids with egg allergies can now get the flu shot, and while many kids with eczema have food allergies, the food allergy isn’t usually thought to make their eczema worse. As part of the atopic march, they just have both – food allergies and eczema. Some also have hayfever or asthma.

In addition to your pediatrician, a pediatric allergist can help you with any remaining concerns about eczema and vaccines. A pediatric dermatologist can also be helpful if you are having a hard time getting your child’s eczema under control.

What to Know About Vaccines and Eczema

Vaccines don’t cause eczema and except for the smallpox vaccine, they won’t make your child’s eczema worse. Experts recommend that kids with eczema be fully vaccinated.

More on Vaccines and Eczema

Rash After the MMR – Is This Normal?

It is not uncommon to get a rash after your child gets their MMR vaccine.

In fact, about 1 in 20 people get a rash after their first dose of MMR.

It typically shows up about 6 to 14 days after the dose.

Fortunately, it doesn’t mean that your child has full-blown measles as some people suspect.

Rash After the MMR

So why do some kids get a rash after their MMR?

It depends on which rash they have.

While there is one classic MMR rash that we think about, there are actually a few other rashes that can occur even more rarely, including:

  • hives – an allergic reaction to the vaccine or one of it’s components
  • petechia and/or purpura – caused by temporary thrombocytopenia (low platelet count) in about one out of every 30,000 to 40,000 doses of vaccine given

And then there is the rash that up to 5% or people get about 7 to 10 days after their dose of MMR – a mild vaccine reaction that goes away on its own without treatment.

Most importantly, the presence of this measles-like rash does not mean that your child has actually gotten measles from the vaccine.

How do we know?

For one thing, the MMR vaccine is made with an attenuated or weakened form of the measles virus, so it can’t actually cause full-blown measles, unless maybe a child has a severe immune system problem.

Also, there is no viremia after vaccination.

“There are no reports of isolation of vaccine virus from blood in normal humans.”

Plotkin’s Vaccines

It is also important to note that “person-to-person transmission of vaccine virus has never been documented.”

And kids who get a rash after their MMR vaccine are not considered to be contagious. At most, you would expect them to shed the weakened vaccine virus, but they don’t.

What’s causing this measles-like rash then?

Like the fever, it is thought to be a delayed immune response to the live, attenuated virus in the vaccine.

When the Rash Really is Measles

Are there any situations in which a child gets a rash after their MMR vaccine and it could really be measles?

Sure.

An infant hospitalized during a measles outbreak in the Philippines in which 110 people died.
An infant with wild type measles hospitalized during a measles outbreak in the Philippines in which 110 people died. Photo by Jim Goodson, M.P.H.

Your child could have been exposed to wild type measles right around the time they got vaccinated, and then went on to develop regular measles.

While getting a measles vaccine within 72 hours of exposure (post-exposure prophylaxis) can reduce your chance of getting measles, it isn’t a perfect strategy.

Or your child could have been vaccinated and been one of the few people for whom the vaccine failed to work. So their rash, again, would be from a wild type strain of measles that they were exposed to and not from the shot.

Can you tell the difference if someone has measles from the vaccine or from a wild type strain?

Sure.

“During outbreaks, measles vaccine is administered to help control the outbreak, and in these situations, vaccine reactions may be mistakenly classified as measles cases.”

CDC on Genetic Analysis of Measles Viruses

You just have to test the measles strain to see if it is the wild type virus or a vaccine strain.

Does It Matter If It Is the MMR Vaccine or Measles?

About now, you are probably wondering why it matters knowing if a child’s rash is caused by measles or the MMR vaccine, right?

For one thing, if a parent thinks a vaccine gave their child measles, then they might not want to get vaccinated again. They will especially think twice about getting another MMR.

Also, if a child really does have full-blown, wild type measles and you simply blame their MMR vaccine, then you might miss someone else in the community that exposed the child to measles. And that’s why some outbreaks are hard to stop.

Lastly, if you simply blame the vaccine, you might miss something else that is causing the child to be sick.

Need an example?

During the 2010 measles outbreaks in Canada, a 15-month-old develop a rash, fever, and other symptoms 12 days after getting their MMR vaccine. Did the have measles, a vaccine reaction, or something else?

Turns out that he had scarlet fever.

The child tested positive for Streptococcus pyogenes (group A streptococcus), the bacteria that causes strep throat and scarlet fever. He also tested positive for vaccine strain measles. He did not have the wild strain of measles, and in fact, did not have measles at all.

Again, he had scarlet fever and it was just a coincidence that he had recently received an MMR vaccine.

But isn’t there another case report from Canada that does prove that you can get full-blown measles from the MMR vaccine? While there is such a case report, it is hardly proof of anything.

“It is possible that the case’s symptoms were not measles-vaccine-related but an inter-current illness confounding the presentation.”

Murti et al on Case of vaccine-associated measles five weeks post-immunisation, British Columbia, Canada, October 2013

The problem with the case?

For one thing, the child already had high levels of IgG antibodies at the time he had the rash, which developed 37 days after he got his vaccine.

“The two-fold rise between acute and convalescent measles-specific IgG suggests the vaccine-mediated immune response had been underway prior to the onset of symptoms.”

Murti et al on Case of vaccine-associated measles five weeks post-immunisation, British Columbia, Canada, October 2013

This was neither a typical reaction nor a typical case. And it very well might not have been measles. If it was, it was a very rare exception to the rule that rashes after the MMR vaccine aren’t full-blown measles.

What to Know About Rashes After the MMR Vaccine

The rash that your child can get after their MMR vaccine is not a sign that they have developed full-blown measles, instead, it is a mild vaccine reaction that will quickly go away without any treatment.

More on Rashes After the MMR Vaccine