Immunologist Dr Annie Curtis intended to get her children vaccinated, but they succumbed to the infection before she got around to it. She talks about the benefits of inoculation against this, and other diseases, and why we need to tackle vaccine hesitancy
Vaccination has never been a hotter topic than it is right now. But while the Covid vaccines are the ones to the fore of all of our minds, there are perhaps more mundane vaccines that we should be thinking about.
Throughout the pandemic, parents have continued to bring their kids for childhood vaccinations. However, the chickenpox vaccination is not included in the childhood schedule of vaccinations provided by the HSE, because for most children, chickenpox tends to be a benign infection with a mild clinical course. For now, if you want to get your child vaccinated, it will cost you around €180 (or €90 per dose) from your GP, but this price can vary from surgery to surgery.
Dr Annie Curtis, a scientist, immunologist and senior lecturer at the Royal College of Surgeons in Ireland University of Health and Medical Sciences, recently found herself locked down in an unexpected way when her two young daughters Lizzie (eight) and Faye (six) contracted chickenpox at the same time. Chickenpox, or varicella, is considered a normal childhood disease, one that children are expected to get as a matter of course. There is no cure for it, but the virus usually clears up by itself without any treatment.
The HSE says the clinical course of chickenpox is generally mild with malaise, itchiness and fever for two to three days and complications are uncommon in childhood. The risk of complications is higher in infants aged younger than one year and in persons aged older than 15 years, particularly pregnant women, smokers and the immunocompromised.
The National Immunisation Advisory Committee recommends that anyone over 12 months can get the chickenpox vaccination, including teenagers, although efficacy in adolescents and adults is slightly lower than that in younger children (75pc vs 86-98pc).
The itchiness, fever and blisters of chickenpox might be categorised as mild, but they are not things our children have to suffer through. “The midwives used to say that the kids were hardier, that it boosted their immune system, but now we know that vaccines boost your immune system really well,” says Dr Curtis. “We know you can get the infection and get it again, but the vaccines are more finely-tuned.”
As an immunologist, Dr Curtis had fully intended to get her own daughters vaccinated, but she had put it off. “I just put it on the long finger. It’s not on the vaccination schedule and then there’s the cost and inconvenience component to it. It sounds like ‘bad mother’,” she laughs, “but I just never got around to it.”
Because of how the incubation period works with chickenpox, and how long the contagious period lasts, Dr Curtis’s daughters ended up at home for nearly a month. “It took about three or four weeks between both of them getting it. It’s a big chunk of time. It can be a huge inconvenience. “And they can be quite sick. I noticed that even though my daughter had cleared the infection, she was still not herself for a while.”
Dr Curtis says the last year of living through Covid has actually increased people’s knowledge and understanding of infectious diseases in general. “We have a greater understanding about viruses now. We know that they infect the person who is sick, but also there is the risk of transmission to others. Everything we’ve learned about Covid we can translate to chickenpox. Chickenpox is an infectious disease.
“In fact, at 3.75, it has a higher R rate than Covid. It is more transmissible, that’s why it runs through schools. I think people see that now with Covid, how one person brings it into the household and they don’t show symptoms for several days and then it can go through a household.”
The last year has changed our thinking around vaccines and immunisation too, Dr Curtis says. “The public understanding has changed so much in terms of infectious disease. We see that vaccines are not our only way out — we have to use them with other measures — but we see that they are a huge weapon. I think what the last year has shown us is how devastating infectious disease can be.”
Having gone through the chickenpox infection with my eldest two children, I made the decision to vaccinate my youngest two against it, but was surprised when another parent wrongly told me that it could leave them at risk of sterility.
“People need to be more informed,” Dr Curtis says. “The misinformation and pseudoscience is fear-mongering. Parenthood and motherhood is a shame spiral. It gets you between the eyeballs, the guilt and the shame. There’s such a platform for misinformation to get out there, and people are getting their information from one place within a bubble. Good dialogue and good education in schools is necessary.”
I wonder if being an immunologist and understanding infectious disease on the level that Dr Curtis does makes her more or less relaxed about childhood illnesses and infections. Understanding the biology behind infectious disease, she says, is really reassuring.
“For people who don’t have that sort of a background, it has been very scary. With something like the HPV vaccine, the risk of some of those conditions are so much greater than Covid. Parents really shouldn’t be in any way worried about bringing kids to get vaccinated. We really need to keep them up to date.”
So what is the main benefit of vaccinating, particularly when it comes to some of the more common childhood illnesses? “It’s something our kids don’t have to get,” Dr Curtis says. “I don’t think there is a downside to vaccinations, they’re highly efficacious and hugely safe, but we can’t dismiss people for vaccine hesitancy.”
She says people should assess the risks when it comes to hesitancy. “As human beings, we’re not great at assessing risk. The blood clots are so rare, the risk of being sick or dying from Covid is greater. If we think about it, these vaccines didn’t just happen overnight. Modern science research has been going on for hundreds of years but the fact that we were able to develop a vaccine in less than a year is one of the greatest achievements of the 21st century. If we didn’t have a vaccine something would have had to give.”
As for how we will emerge from this pandemic, Dr Curtis doesn’t think life will ever go back to how it was before. “I think we’re always going to wear masks in certain situations from here on in, particularly in flu season. “I often think about what’s happened in the 21st century. We’ve had Sars, bird flu, Mers, Ebola, swine flu.
“You don’t want to put the mockers on people but there have been more epidemics and pandemics in the 21st century than we’ve seen in the previous 100 years. The virologists will say Covid is not even the big one. If we were smart and planned for the future, SARS-CoV-2 should be a lesson and we need to take on these lessons. People are making the connection between washing their hands and ventilation, and we need to take these on as being really quite serious lessons.”
Why has there been such an increase in infectious diseases in this century? “If you talk to environmental scientists, it’s a combination of how we use the land, other species and climate change. It’s a combination of that and how we travel, how we interact, mass travel, how our lifestyle has changed so much in the last 100 years. None of us were zipping across multiple time zones 100 years ago. The planet hasn’t been able to keep up pace and we need to look at that.”
Perhaps a good way to look at what vaccines have done for our world is to try to imagine life without them. “Our life expectancy would be quite short because the bug would kill us,” says Dr Curtis. “We’d be taken out. Now what kills us are lifestyle diseases, cancer, Alzheimer’s. Science has allowed us to develop these medicines that have transformed our world, and we need to prioritise them.”