Slate's Medical Examiner: Chickenpox Vaccine Risks

The chickenpox vaccine has been a boon to American children for the last 10 years, but it may have an unintended consequence — putting adults at higher risk for shingles, a related illness. Madeleine Brand speaks with Yale University professor, pediatrician and Slate contributor Sydney Spiesel about the chickenpox virus and the risks of the vaccine.

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MADELEINE BRAND, host:

This is how chicken pox use to work. You got it. You itched like crazy for a week and you were over it, forever. But a vaccine became available about ten years ago, and since then many children in the United States have been inoculated.

Sydney Spiesel is a pediatrician and professor at Yale Medical School. He writes about medical research for the online magazine Slate. And he joins us today to talk about what we've learned during a decade of chicken pox vaccinations.

And Syd, welcome back.

Dr. SYDNEY SPIESEL (Professor, Yale Medical School): Thank you, nice to be here.

BRAND: Now, since chicken pox is thought to be a fairly mild illness, a lot of parents might wonder why they need to vaccinate their children.

Dr. SPIESEL: Well, chicken pox is, and has been, traditionally a fairly mild illness, with occasional quite serious consequences. You know, before we introduced the vaccine, there were about an average of about four million cases a year in the United States. Now, of those four million cases, about 12,000 kids wound up in the hospital. And there were an average of, oh, I don't know, something like over 140 kids a year who died from chicken pox. So anyway, that's one of the reasons for the, why the vaccine is important.

BRAND: So when children are vaccinated against chicken pox, does that mean they're safe for their entire lives?

Dr. SPIESEL: Almost but not quite. The vaccine does decrease in protection very slowly, and probably many kids will be protected for the rest of their life. But a small number of them do seem to have lost some or part of their protection over time.

BRAND: And so is there any downside to the vaccine?

Dr. SPIESEL: Once you get chicken pox, for the rest of your life you'll carry it in a latent form, the chicken pox virus. And every once in awhile it blossoms out in adults, and causes this very unpleasant disease called shingles; a lot of pain, a lot of disabilities. It's a very bad disease. It's now believed, or at least it's believed by some people, that exposure to children with natural disease would keep boosting the immune response of adults, and decrease the risk for shingles breaking out.

And so that may be a downside, that maybe now that we're immunizing everybody, adults will not be exposed to children with the disease, and therefore are at greater risk for shingles. But now the company that makes the vaccine has been testing, and is now marketing a more potent version of the chicken pox vaccine that's designed exclusively for adults to prevent them from ever having shingles.

BRAND: Hmm. Syd, have you heard of this phenomenon called chicken pox parties?

Dr. SPIESEL: In the old days, chicken pox was thought to be so benign that it was thought that well, it would be convenient if you could control when children would get the disease. And so somebody would break out in chicken pox, and so there'd be a party to expose people. These days, fortunately, we don't even need to think about that because we can give people the vaccine and prevent the need for that at all.

BRAND: Well, let me break it to you, Syd. We have heard of instances where people are holding these parties because they don't trust the vaccine. They don't like vaccines and they prefer to do it the old fashioned way.

Dr. SPIESEL: Well, I hope none of my patients are doing this. I mean, I know that there're many people in the world who are suspicious of vaccines. But most of them, I think, provide quite good protection. I think the chicken pox vaccine is one. It's a safe and protective vaccine. So I would always vote in favor of the vaccine rather than the chicken pox parties.

BRAND: Dr. Sydney Spiesel writes for slate.com and he teaches at the Yale Medical School.

Thanks again, Syd.

Dr. SPIESEL: Oh, you're welcome. Nice to be here.

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