Tag: shingles

Can the Chickenpox Vaccine Cause Meningitis?

Why do some folks think that the chickenpox vaccine can cause meningitis?

Because they are misrepresenting a case report about two vaccinated teens who later developed shingles and meningitis, with a vaccine strain of chickenpox.

Can the Chickenpox Vaccine Cause Meningitis?

While that does sound like the chickenpox vaccine caused them to have meningitis, since it was a vaccine strain, it is very important to keep in mind that a natural chickenpox infection can do the exact same thing.

“Like wild-type virus, vOka can establish latency in sensory ganglia after immunization and may reactivate, leading to HZ.”

Harrington et al on Vaccine Oka Varicella Meningitis in Two Adolescents

Anyway, as can happen after a natural chickenpox infection, these two vaccinated teens developed shingles (HZ or herpes zoster).

“vOka varicella rarely results in meningitis, which is thought to occur after reactivation in a proximal dorsal root ganglion with spread to the central nervous system.”

Harrington et al on Vaccine Oka Varicella Meningitis in Two Adolescents

Unfortunately, whether the reactivation occurs after getting the chickenpox vaccine or a natural chickenpox infection, it can cause meningitis, as it did with these two teens.

So why get vaccinated?

In addition to avoiding chickenpox and its complications, getting vaccinated and protected with the chickenpox vaccine lowers your risk of later developing shingles.

“Viral meningitis accounts for approximately 26,000 to 42,000 hospitalizations each year in the United States, affecting mainly infants younger than one year, children 5–10 years of age, and the immunocompromised. Varicella Zoster virus is responsible for about 11% of those cases. Varicella can infrequently lead to Encephalitis resulting in seizures and coma (estimated 1.8 per 10,000). Other rare but serious complications of VZV include transverse myelitis, guillain-barré syndrome, thrombocytopenia, hemorrhagic varicella, purpura fulminans, glomerulonephritis, myocarditis, arthritis, and hepatitis.”

Gnoni et al on Varicella Zoster aseptic meningitis: Report of an atypical case in an immunocompetent patient treated with oral valacyclovir

And if you don’t get shingles, you shouldn’t get meningitis!

“To the best of our knowledge, these are the first cases of vOka meningitis described in adolescent patients who received 2 doses of varicella vaccine.”

Harrington et al on Vaccine Oka Varicella Meningitis in Two Adolescents

Although these teens were vaccinated, there are even more case reports of unvaccinated children and adults developing chickenpox (varicella zoster) meningitis and shingles (herpes zoster) meningitis.

That’s one of the reasons that these are life-threatening diseases that most of us try to avoid by getting vaccinated and protected!

As much as anti-vax folks are sharing this case report, it isn’t a good reason to skip or delay your child’s chickenpox vaccines. In fact, not getting vaccinated will almost certainly raise your child’s risk of developing chickenpox meningitis, from the natural strain.

More On Meningitis After the Chickenpox Vaccine

Can Vaccines Cause Herpes Infections?

It’s very easy to understand why some folks believe that vaccine injuries are so common.

Vaccines don't cause eczema and they certainly don't cause herpes.
Vaccines don’t cause eczema and they certainly don’t cause herpes.

It’s because they think that vaccines are poison and everything is a vaccine injury, even an infant’s herpes infection!

Can Vaccines Cause Herpes Infections?

Wait, could someone actually get herpes from a vaccine?

Yes, which vaccine causes this???
Yes, which vaccine causes this???

Do we even have a herpes vaccine?

Chickenpox, shingles, and herpes are all members of the herpesviridae family of viruses, but they are not all herpes.

As most people understand, we do have a herpes zoster vaccine, but that is for shingles – and it has nothing to do with the actual herpes virus. Remember, shingles got the name herpes zoster before it was known that it was actually caused by the chicken pox virus (varicella zoster).

And while there is a very large herpesviridae family of viruses, which includes the herpes simplex virus that causes cold sores (HSV1) and genital ulcers (HSV2) and the chickenpox virus, it also includes viruses that cause mono (EBV) and roseola (HHV6 and 7).

Still, only HSV actually causes herpes.

So no, none of the viruses we get could actually cause herpes.

It is thought that nearly 48% of people have HSV1 though and that you can be contagious, shedding the herpes virus even if you don’t have an active cold sore.

Where is the evidence for vaccines being contaminated with herpes viruses?
Where is the evidence for vaccines being contaminated with herpes viruses?

So what’s more likely, an infant was exposed to someone with HSV1 and got infected or they received a vaccine that was contaminated with HSV1, something that has never been documented?

What are some other “possibilities?”

Could it be eczema vaccinatum?

While eczema vaccinatum is a thing, it is a thing that occurs when someone with eczema gets or is exposed to someone who has recently had the smallpox vaccine.

Eczema vaccinatum has to do with the smallpox vaccine...
Eczema vaccinatum has to do with the smallpox vaccine…

It is why the AAP once considered eczema a contraindication to getting vaccinated.

It is unlikely that the infant pictured above was exposed to someone who recently had the smallpox vaccine though and he doesn’t have eczema vaccinatum anyway…

Colloidal silver or CBD oil on eczema???
Colloidal silver or CBD oil on eczema???

And no matter how confident these folks are in their advice to treat and diagnose this baby, they are wrong.

It's truly mind numbing when these folks try to blame everything on vaccines.
It’s truly mind numbing when these folks try to blame everything on vaccines.

Everything isn’t a vaccine injury.

It is always the vaccines...
It is always the vaccines…

What happens if parents actually start to believe anti-vaccine folks who are claiming that HSV1 infections are caused by vaccines?

How do vaccines cause herpes virus?
How do vaccines cause herpes virus?

In addition to skipping or delaying vaccines, putting their kids at risk to get pertussis, measles, Hib, and other vaccine-preventable diseases, they might not take precautions to actually keep them from getting herpes!

Fortunately, most kids with herpes do well if they are outside the neonatal period - after they are about a month old.
Fortunately, most kids with herpes do well if they are outside the neonatal period – after they are about a month old. Hopefully this mom posts an update to the anti-vax group too.

And we will see more kids ending up in the hospital or dying with herpes infections.

More on Vaccines and Eczema

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

Why Are Vaccine Schedules Different in Each Country?

Anti-vaccine folks often point in differences in the immunization schedules in various countries to try and make a case that some countries do things better than others.

Is that true?

Why Are Vaccine Schedules Different in Each Country?

The ACIP and CDC set the immunization schedule in the United States, but it shouldn’t be surprising that other countries have their own systems to set their schedules.

Each country vaccinates according to their own needs, so none of their schedules are wrong, even though they are all a little different.
Each country vaccinates according to their own needs, so none of their schedules are wrong, even though they are all a little different.

And no, just because they are all a little different, that doesn’t mean that any are wrong.

That’s easy to understand once you do just a little research on how these immunization schedules are set up.

The WHO immunization schedule.
The WHO immunization schedule.

The WHO immunization schedule is set by the Strategic Advisory Group of Experts (SAGE) on Immunization.

WHO vaccine position paper development is "a complex, rigorous, multifaceted process."
WHO vaccine position paper development is “a complex, rigorous, multifaceted process.”

It’s basically a summary of WHO position papers.

The WHO recommendations help other countries develop optimal immunization schedules.

The Communicable Diseases Act in Sweden regulates the 13 factors that the Public Health Agency of Sweden must account for when proposing changes in the national vaccination programme to the Government.
The Communicable Diseases Act in Sweden regulates the 13 factors that the Public Health Agency of Sweden must account for when proposing changes in the national vaccination programme to the Government. 

Many countries also have their own National Immunization Technical Advisory Group that sets their immunization schedule.

So their immunization schedule is right for their country, even if it doesn’t match the United States schedule.

Australia’s Vaccine Schedule

In Australia, for example, the National Immunisation Program (NIP) Schedule is set by National Immunisation Committee (NIC), which reports to the Australian Health Protection Principal Committee (AHPPC) of the Australian Health Ministers Advisory Council (AHMAC) through the Communicable Diseases Network Australia (CDNA).

The Australian Technical Advisory Group on Immunisation (ATAGI) also provides technical advice on the operation of the National Immunisation Program.

Combination vaccines mean infants in Australia get fewer shots, but the same number of vaccines.
Combination vaccines mean infants in Australia get fewer shots, but the same number of vaccines.

Notice any differences between Australia’s vaccine schedule and the US schedule?

  • they give the routine second dose of MMR earlier, at 18 months
  • they don’t give a second dose of the chickenpox vaccine
  • they give the routine first dose of the meningococcal vaccine earlier, at 12 months
  • the hepatitis A and flu vaccines are only given to high risk kids

While there are some minor differences, it is fairly similar to the US immunization schedule.

“There is a legislative requirement for all vaccines provided under the NIP or the PBS to undergo a thorough and objective assessment process.”

National Immunisation Strategy for Australia

Why the earlier dose of meningococcal vaccine?

This is a good example of why immunization schedules vary between countries.

“The notification rate for meningococcal disease to the National Notifiable Diseases Surveillance System peaked at 4.3 per 100 000 in 2002 and declined to 0.4 per 100 000 in 2013.”

Meningococcal disease

Meningococcal disease incidence rates in the United States were much lower, about 0.6 per 100,000, when they started giving meningococcal vaccines in Australia (2001).

The UK Vaccine Schedule

But aren’t the immunization schedules from other countries supposed to be a lot different from the US schedule?

Let’s look at another…

The Joint Committee on Vaccination and Immunisation (JCVI) advises UK health departments on immunisation.
The Joint Committee on Vaccination and Immunisation (JCVI) advises UK health departments on immunisation.

It’s not the easiest schedule to read, but you should notice that vaccines for hepatitis A and chickenpox are missing, but younger children get extra meningococcal shots.

You may also have noticed yet another dosage schedule for the Prevnar 13 vaccine.

While the United States gives a three dose primary series and a booster, many other countries give either a three dose primary series alone or a two dose primary series with a booster.

“A large and growing body of evidence from immunogenicity studies, as well as clinical trials and observational studies of carriage, pneumonia and invasive disease, has been systematically reviewed; these data indicate that schedules of 3 or 4 doses all work well, and that the differences between these regimens are subtle, especially in a mature program in which coverage is high and indirect (herd) effects help enhance protection provided directly by a vaccine schedule.”

Whitney et al on Dosing schedules for pneumococcal conjugate vaccine: considerations for policy makers.

That doesn’t mean that they are all guessing at the dose! All of these schedules are well studied and in this case, there isn’t much difference.

There are even studies that suggest giving only one primary dose, combined with one booster dose might work, but only in areas where pneumococcal disease is already well controlled and infants would be protected by indirect herd immunity.

But that doesn’t mean that other schedules would work just as well too. For example, giving the doses later or on a slower schedule would not be better.

Why not?

Infants are most at risk for many of these diseases, especially Hib and pneumococcal disease, when they are young and delaying when infants get vaccinated simply leaves them unprotected and at risk to get sick for a longer period of time. You also want infants to be protected by the time they lose the passive protection they get from their maternal antibodies.

What about the chickenpox vaccine?

Will the UK get the chickenpox vaccine soon?

While the UK has not added the chickenpox vaccine to their schedule because their models predicted an increase in cases of shingles (which has happened anyway) with a decrease in exogenous boosting (the theory that exposure to chickenpox lowers your risk of shingles), they are now looking at this again.

“This study confirms that severe complications of varicella, including death, continue to occur in the UK and Ireland.”

Cameron et al on Severe complications of chickenpox in hospitalised children in the UK and Ireland

Mostly it has been said that the chickenpox vaccine isn’t on the schedule because they have not thought it to be cost effective.

Iceland’s Vaccine Schedule

When anti-vaccine folks talk about immunization schedules from other countries, they aren’t usually talking about the UK or Australia though.

They are talking about Iceland, the country that they believe gives far fewer vaccines than the United States.

You thought they gave even fewer vaccines in Iceland, didn't you?
You thought they gave even fewer vaccines in Iceland, didn’t you?

Vaccines for flu, chickenpox, hepatitis A, and hepatitis B and also available for those who are considered high risk.

Extra vaccines are available for high risk kids.

Want to follow Iceland’s immunization schedule?

Then you should move to Iceland.

Hopefully you are starting to see that immunization schedules are different in each country because each country has different rates of disease, different populations, and different healthcare systems.

Iceland is a small country (338,349 people), with high vaccination rates, and universal health care. Compare that to the United States, with 327,200,000 people, clusters of unvaccinated people, and lots of people without health care.

It should be easy to see that what works in one country might not work in the other…

Vaccine Schedule Comparison by Country

What about other countries?

Austria’s immunization schedule for 2019 includes all of the same vaccines as the US schedule, plus the vaccine for Japanese encephalitis (if high risk).
Austria’s immunization schedule for 2019 includes all of the same vaccines as the US schedule, plus the vaccine for Japanese encephalitis (if high risk).

On the immunization schedule in Austria, the columns in red are for vaccines that are recommended and free. The blue columns are also recommended, but they aren’t free.

The chickenpox vaccine was just added to Japan's routine vaccine schedule, but they still don't give the combined MMR vaccine. They do still have autistic kids, so does that finally prove that the MMR vaccine is not associated with autism?
The chickenpox vaccine was just added to Japan’s routine vaccine schedule, but they still don’t give the combined MMR vaccine. They do still have autistic kids, so does that finally prove that the MMR vaccine is not associated with autism?

Japan has two separate schedules – the routine schedule for everyone (in dark blue above) and the voluntary schedule, with extra vaccines. Note that the primary series of infant vaccines are given at 2, 3, and 4 months.

The latest vaccine schedule in Germany.
The latest vaccine schedule in Germany.

Germany also gives their primary series of infant vaccines at 2, 3, and 4 months.

In contrast to the 16 diseases that kids in the US are vaccinated against, Sweden uses vaccines for just 9.
In contrast to the 16 diseases that kids in the US are vaccinated against, Sweden uses vaccines for just 9.

Sweden is the other country that anti-vaccine folks like to talk about a lot. Mostly because they think that Sweden recently banned mandatory vaccination. They didn’t.

And note that kids in Sweden can get vaccinated at school!

The Norwegian immunization program makes heavy use of combination vaccines.
The Norwegian immunization program makes heavy use of combination vaccines.

Norway is studying adding chickenpox and Shingles vaccines to their schedule.

Switzerland now offers a few optional vaccines for folks who want them, including the meningococcal vaccine, HPV vaccines for boys, and the shingles vaccine for seniors.
Switzerland now offers a few optional vaccines for folks who want them, including the meningococcal vaccine, HPV vaccines for boys, and the shingles vaccine for seniors.

Although they only use a two dose primary series, Switzerland gives many of the same vaccines as the United States.

The 2018 vaccination schedule in the Netherlands. New additions in 2020 will be the rotavirus vaccine or high risk infants, Tdap in pregnancy, and MenACWY for teens.
The 2018 vaccination schedule in the Netherlands. New additions in 2020 will be the rotavirus vaccine or high risk infants, Tdap in pregnancy, and MenACWY for teens.

Are you surprised to see that infants in Holland get more vaccines before they turn 12 month old than infants in the United States and an extra set by four months?

While most vaccines are free, you can pay extra to get vaccines that are already on the United States schedule in most other countries.
While most vaccines are free, you can pay extra to get vaccines that are already on the United States schedule in most other countries.

Even if they aren’t routine in other countries, all of the same vaccines that are offered in the United States, including vaccines to protect kids against rotavirus, chickenpox, and hepatitis A, are available in most other countries.

Vaccination schedule for children and adolescents in Israel.
Vaccination schedule for children and adolescents in Israel.

The latest immunization schedule in Israel includes hepatitis B, DTaP, polio, pneumococcal, rotavirus, MMR, chickenpox, HPV, and flu vaccines.

The 2019 Immunization Schedule for South Korea includes almost all of the US vaccines, plus BCG and Japanese encephalitis vaccines.
The 2019 Immunization Schedule for South Korea includes almost all of the US vaccines, plus BCG and Japanese encephalitis vaccines.

What’s missing in South Korea’s immunization schedule? Meningococcal vaccines. But they do have some that we don’t give in the United States.

What’s missing in Denmark?

Vaccines for rotavirus, chickenpox, hepatitis A or B, and meningococcal disease are not offered for free, but are still available in Denmark.

Folks who don’t vaccinate their kids!

Denmark has very high immunization rates – over 97% for infants and toddlers!

In addition to free vaccines, the Danish vaccine program offers these vaccines that folks can ask for and pay for themselves. Some people in high risk groups can get them free.

What don’t these different immunization schedules influence?

Prevalence rates of autism, SIDS, and other things that scare parents away from vaccinating and protecting their kids.

The One Wrong Way to Give Vaccines

Since the immunization schedules from all of these countries are just a little bit different, does that support the idea that an individualized approach to vaccinating kids is a good idea?

There is no science and nothing that says altering any vaccine schedule is a safer or more effective way to do things.
There is no science and nothing that says altering any vaccine schedule is a safer or more effective way to do things.

Of course not!

"Later and slower" is not part of any immunization plan.
“Later and slower” is not part of any immunization plan.

In many countries, even if they are missing protection against a few diseases that we routinely vaccinate against in the United States, many get their vaccines earlier! And all start by three months and don’t split up the schedule to just give one or two vaccines at a time.

Everyone knows that later and slower just leaves kids unprotected for longer periods of time. More risks. No extra benefits.

More on Vaccine Schedules Around the World