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By Dr Richard Angwin
Varicella (chickenpox) is a nasty, highly contagious viral disease. While mostly a mild disorder in childhood, varicella tends to be more severe in adults. It may be fatal, especially in children under one year old and in those with an immunity problem. It may also cause shingles.
Varicella vaccines have been marketed since 1974. They have been introduced into the childhood immunization programmes of several industrialized countries. After observation of study populations for periods of up to 20 years in Japan and 10 years in the US, more than 90% of people with a healthy immune system who were vaccinated as children were still protected from varicella. It is not known if this level of immunity results from vaccination or from re-exposure to the natural virus in the community.
Partial vaccination of a local population could actually create a risk that the disease will become more prevalent in older children and adults – the group at risk of more severe disease.
Studies have shown that vaccine given within 3 days of exposure to varicella gives a 90% chance of protection against developing the illness.
My personal view is that until the vaccine is introduced as a routine childhood vaccination, varicella vaccine should be reserved for older children or adults who are not immune. A good case for vaccination can also be made in those non immune individuals who have been exposed to the virus within 3 days and in whom the disease would pose a serious inconvenience.
