Many times during the past week, I wished my kids had been vaccinated
against chickenpox. It’s a miserable disease, and I hated to see them suffer
But overall, it’s a fairly mild disease when left to run its course among
children. Children with chickenpox rarely experience complications. Adults,
pregnant women, and immuno-suppressed people experience much more severe cases
and sometimes death. The chickenpox vaccine – Varivax – is not currently
"required." However, the American Academy of Pediatrics recommends
it, and it seems likely to follow in the wake of the other standard (and
currently required) vaccines against childhood illnesses – measles, mumps and
So is there a problem? Should we not be grateful to Merck – the maker of
the vaccine – for saving us from this significant annoyance? Bringing a
layperson’s curiosity, parental concern for my own little ones soaking in
their oatmeal baths, and an inbred distrust of large pharmaceutical companies
and the FDA, I dipped into the available literature on the chickenpox vaccine
– a book from my library, numerous newspaper articles, medical journals, and
various web sites. Following are some of my concerns:
The vaccine is known to provide only temporary immunity, whereas actually
contracting the disease is known to provide life-long immunity. Providing
temporary immunity to children could drive chicken pox disease into the older
adult population where it can cause many more deaths and complications.
Merck – the pharmaceutical company that makes the chickenpox vaccine – has
been ordered by the FDA to follow vaccinated children for 15 years to better
understand how long they can expect to enjoy immunity. Clearly, individuals
need to be studied much longer – 80 years and more – to know whether the
vaccine’s immunity follows them into old age.
On the topic of longitudinal studies, how do we address the fact that
varicella and its human hosts have been evolving together for thousands of
years? Varicella developed the important knack of not killing off its host.
Instead, it just causes minor illness, spreads easily through groups of
children, and then lays dormant in the nerve cells until it (occasionally)
emerges decades later as shingles. This painful re-emergence of the varicella
virus makes the victim contagious for chickenpox. Anyone without immunity who
comes into contact with someone with shingles is likely to come away with
chickenpox. Thus, the ingenious varicella virus survives in its host,
reactivating itself decades later with the ability to infect a whole new
population of children.
In the process of fighting off chicken pox, children’s immune systems go
through the important exercise of identifying an unfriendly viral invader and
rallying the body’s resources to develop the proper antibodies in response.
Some doctors believe that childhood illnesses such as chickenpox provide a
training opportunity to the immune system, arming it with the
"knowledge" and "experience" of fighting off disease that
come in handy later on in life.
Furthermore, adult immune systems already equipped with chickenpox
antibodies, continue to get stronger and develop as they come into contact
with the varicella virus. Pediatricians who frequently see children with
chickenpox tend to have powerful antibodies to the disease, and, so, rarely
contract shingles later in life. During this last week and a half, in the
process of taking care of my virus-ridden children, my immune system geared up
against the disease, produced extra antibodies, and perhaps further refined
itself, equipping me with disease-fighting power.
Is there any value to this immune system training? I don’t know for sure.
The question has not been studied. When Merck tracks the effect of the
chickenpox vaccine, they do not ask what the cost to our immune system is. But
they do look at short-term financial trade-offs. The vaccine costs about $40
per child, the argument goes. The annual cost to "society" of
hospitalizations and lost work is estimated to be more than $400 million by
the Center for Disease Control in Atlanta. The obvious short-term financial
savings justify the vaccine.
Suddenly concerned with the practical aspects of a single mother’s life,
the head of the University of Florida vaccine study says, "If you have a
single mother with five children and one child comes down with chicken pox,
the mother either has to take off work or hire a baby sitter. When one child
comes down with chicken pox, two weeks later another one comes down with it
and then other cases may follow. A mother in such a family is literally out of
work or paying for a babysitter for a month or more."
True. It is no piece of cake to nurse any number of children through the
disease. And it’s even harder in this society – with so many uninsured, rare
instances of unpaid sick leave, and even rarer instances of paid time off to
care for sick family members. The vaccine could be quite practical to a single
mom of five children, but let’s not accept that as a solution. A quick-fix
vaccine should not direct our attention away from larger political goals and
supports for families – such as universal health care and adequate benefits.
Other deeper concerns could be addressed as well. While Merck lines its
pockets with profits through the sale of a vaccine that protects against one
isolated virus, who is addressing themselves to our immune system’s other
needs? Such as an adequate diet, cleaner air and water, access to such
stress-reducing resources as adequate housing, decent schools, fulfilling
There are lots of ways we need to take care of ourselves, our children, and
our single mothers. Varivax might indeed be a life-saving vaccine for some who
are most vulnerable to the virus, and it should be an option for people.
However, health protections should not be based only on short-term gains. It
may be that our immune systems are somewhat inconvenient to maintain: they
need the occasional annoying battle with a virus; they need bodies that are
adequately nourished and cared for. Nor should health protections be based on
the needs of a profit-driven economy that wants to prevent illness because
illness is inconvenient.