Saturday 23 February 2019

Chicken pox: should I get the vaccine for my daughter?

The vaccine is not part of the routine childhood immunisation programme
The vaccine is not part of the routine childhood immunisation programme

Q Should I get the chicken pox vaccine for my eight-month-old daughter who is in a crèche? What are the dangers to the under-ones of catching the disease? And why isn’t it part of the childhood vaccination scheme?

Dr Nina replies: Chicken pox (varicella) is one of the few childhood viral illnesses that we still see regularly.  It causes an extensive, intensely-itchy blistering rash that can occur all over the body. Infection occurs most commonly in young children but can occur at any age. It is highly contagious and is spread by secretions or by direct contact to the skin lesions themselves.

Most people have fever and flu-like illness for several days before the rash appears. The rash starts on the trunk and face and then spreads rapidly all over the body. It starts as small, slightly-raised red spots, which blister and then finally crust.

A person will develop the illness about seven to 21 days after being exposed to the virus. It is contagious from 48 hours before the rash appears until 24 hours after the last spot has crusted (usually five to seven days). It is necessary to stay out of work, school or crèche for this time. The average amount of spots is 200 but in people with other illnesses or skin conditions, there can be many more. In most children chicken pox causes discomfort related to the fever and itch but passes off with no serious problems. It is not always necessary to see a doctor.

However, in adults or in children with other illnesses, there can be more severe complications . The most dangerous of these are encephalitis (brain inflammation), pneumonia or infection of the skin from scratching. If the fever is not settling or if there is associated headache, drowsiness, shortness of breath or ooze from the blisters, it is important to see a doctor.

Vaccination against chicken pox is part of routine childhood immunisation in some countries but is not routinely given here, and there are no active plans to introduce it. The reason for this is not clear but any mass-vaccination campaign decision is usually made on a cost-benefit analysis.

We have introduced other vaccines such as meningitis B and rotavirus more recently to the childhood immunisation programme. HPV for boys is next. Chicken pox vaccine is offered to health care workers, or those with lowered immunity that are considered at risk. Many parents are now requesting and paying for the varicella vaccine. This is a live vaccine and two doses are required at least four weeks apart to maximise immunity.

It is usually given over 12 months of age as it is felt that the body responds best to live vaccines after this age. Most GPs are happy to arrange vaccination for children. The only barrier is the cost. This vaccine is not provided by the HSE, thus your doctor must order it in. Vaccination is not covered under the Under-6s GP visit card either, so there is a charge for the vaccination and it’s administration.

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