Do You Want to Prevent Chickenpox and Painful Shingles?
Do You Want to Prevent Chickenpox and Painful Shingles?
Almost every child got the chickenpox before we had a vaccine. Many patients would tell me their mother told them all their brothers and sisters had chickenpox, but they never had them. However, when we did a blood test for antibodies to the virus it was present in 90-95% of people that were sure that they never had chickenpox. That means that they had chickenpox. The truly uninfected women that are pregnant with their second child are at high risk of serious complications if their first child comes home with chicken pox. Since the chickenpox vaccine is a live attenuated (weakened) vaccine it can not be given to women while they are pregnant. It can only be given before pregnancy. If you are sure that you had chickenpox as a child or the chickenpox vaccine after 1995 then no testing is necessary. If you are a woman planning future childbirth and were told you “never had chickenpox” or the chickenpox vaccine, then you should be tested now and given the chickenpox vaccine before a planned or unplanned pregnancy if you test negative for chickenpox.
One of my pregnant patients got chickenpox during her second pregnancy when her first child came home from school with chickenpox. It went down into her lungs and she almost died. She went into premature labor and was in a coma on a respirator for several weeks. She and the baby lived but 40% of pregnant women with pulmonary chickenpox die. These are preventable deaths if they get tested and receive the chickenpox vaccine BEFORE getting pregnant.
The chickenpox vaccine became available in the US in 1995. Since that time the number of cases of chickenpox has been reduced by over 90% (1). In 1992 (3 years before the vaccine) there were 158,364 US cases reported to the CDC. There were also 100 deaths in the US from chickenpox that same year. In 2015 (after the vaccine became available) there were only 10,172 cases and 4 deaths. Smallpox killed 1/3 of it’s victims (80% of infants with smallpox died) in the past. Thanks to our parents and grandparents insuring that we received the smallpox vaccine, it has been eliminated from the world and vaccines for smallpox are no longer necessary. Diseases carried only by humans (smallpox and polio) once eliminated will no longer require vaccines. Some diseases (like flu) are also carried by animals (birds and pigs) so in the fore-seeable future flu will always require a vaccine.
Shingles is just a recurrence of the chickenpox you had as a child. It is caused by the varicella-zoster virus (VZV). When you get chickenpox as a child the virus hides inside a nerve in your body and “hibernates” for years, like a bear during winter. It is still alive but “sleeping”. As we get older and our immune system gets weaker the chickenpox pops back up in a band (of often painful blisters), like a belt on one side or the other of your body. These areas can be very painful, sometimes for years after the blisters heal. This is called Post Herpetic Neuralgia (PHN). PHN has no treatment or cure. It can only be prevented with the shingles vaccine. One out of every three people over 60 will get shingles unless they receive the shingles vaccine. Shingles can recur, so even people that have had shingles should get the vaccine.
A new shingles vaccine was just released last year (2). It is called Shingrix®. It requires two injections at least two months apart. It is much stronger than the old shingles vaccine and can be given to people 50 years old or over. It is 90% effective (the old vaccine, Zostavax®, was only 50% effective). It is even recommended for people that had Zostavax®. For more vaccine information go to the CDC vaccine website (2).
References
- https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/E/reported-cases.pdf
- www.cdc.gov/vaccines/adults