Varicella Vaccine Robyn Mauldin-McLeod

What this is… Overview Complications Methods of exposure prior to the vaccine Description of the vaccine- benefits and risks Example of a case where this information is relevant Argument for the use of the Varicella vaccine from personal experiences

About Varicella Comes from the Varicella Zoster Virus Varicella (chicken pox)- childhood Herpes Zoster (shingles)- late adulthood Chickenpox: fluid filled skin lesions that scab, crust over, and fall off Treatments: home remedies such as oatmeal baths, covering children’s hands so they won’t itch, or using lotions Academic concerns: students typically miss 5-6 days

My Case Kindergarten class outbreak 10 bumps Did not know if it was a mild case or something completely unrelated Pediatricians thought that I would be likely to get it if exposed to it again Kindergarten

Chickenpox Parties Also known as exposure parties Parents would exposure their child to one with chicken pox so they would get the virus at a younger age. Common before vaccine Raises concern about willfully spreading infectious diseases

My “parties” Brother had a typical case Neighborhood friend had a cousin who was invited to come to the park Did not develop chickenpox My brother at the age he had the virus Fun times at Crowe Park

Complications Rare severe complications Adults and adolescents, pregnant women fetuses, newborns, infants, and people with compromised immune systems at risk Complications: infections, high fevers, dehydration, vomiting, diarrhea, encephalitis, pneumonia, Reye’s syndrome etc. Can result in hospitalizations or death

Why I was at risk? Not sure that I ever had the chickenpox Parties unsuccessful Close to adolescence. My mother, a nurse, was concerned about me getting it when I was older

The development of the vaccine Developed in Japan in 1974 US since 1995 Live attenuated virus Prevents chickenpox in 70-90% of people (mild case) MMRV (measles, mumps, rubella, varicella) vaccine Most states including North Carolina now require it for entering daycare and kindergarten

Pros Cons Shingles are less common with vaccine Less hospitalizations since vaccine If people develop chickenpox approx. 50 lesions (typical wild case 300-500) More cost effective (cost of vaccine versus cost of hospitalization) People still can get Varicella People who are allergic to neomycin and gelatin may develop allergic reactions Adults may run a low grade fever Rash may develop (MMRV vs. MMR or Varicella) More research still needed about long term immunity

My initial vaccination Got the vaccine in 1996 11 years old No symptoms Was new vaccine but this would now be considered a “catch up” because of my age

New developments Recommend to be given in two doses (initial with booster shot given 4-6 years later) North Carolina requirements-1 dose if born in 2001 or later

Should I get another vaccine? Microbiologist told me of recommendations of another dose I work in a preschool (not-state run) and don’t have access to vaccination information Discussed with my physician

Varicella Outbreak Students in NC who are born before 2001 are not required to have been vaccinated Adults with shingles Outbreak recommendations Students-lesions crust (non-contagious) Adults with Herpes Zoster-Antiviral medications Vaccination (families, peers, 2nd dose) Notification Letters to parents

An advocate for the Vaccine Another dose Didn’t develop any symptoms (Tetanus booster in other arm the same day) Soreness around Tetanus shot but not Varicella Older non-vaccinated students coworkers with shingles Complications in adulthood Discovered from fiancé's case that it recommended when traveling abroad Both Chicken pox free due to Varicella Vaccine!

References Campos, A. J., Varicella Zoster virus. Retrieved April 18, 2009 from http://www.hopkinsmedicine.org/heic/ID/vzv/ Davis, M. M. et al. (2004). Benefits of Varicella vaccine. Pediatrics, (114) 786-792. Chickenpox vaccine: What you need to know (2008). In Centers for Disease and Control online Retrieved April 17, 2009 from http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-varicella.pdf Exposure parties (2007). In National Network for Immunization Information database. Retrieved April 18, 2009 from http://www.immunizationinfo.org/exposure_parties_detail.cfv?id=20 Varicella (chickenpox) vaccination (2009). In Centers for Disease and Control online Retrieved April 17, 2009 from http://www.cdc.gov/vaccines/vpd-vac/varicella/default.htm