Chickenpox & Shingles

Axel HeaderNowadays, all adults have suffered or seen chickenpox: children covered in itchy little pimples and blisters who are kept at home to not spread it to all their friends. The main concern is about scratching the blisters, particularly on the face, because they form a little dimple-like scar.

What most people do not know is that the chickenpox-virus never leaves us again, but persists living within us peacefully in the small nerve clusters which run along the spine.

Peacefully until… well, nobody really knows, but until it escapes its golden cage near the spine, experiences its second youth, runs away and causes a second outbreak, which in this case is not called chickenpox, but shingles or Herpes Zoster. This will then be limited to the extension of the particular nerve where it had been living so far and causes a, more or less, annoying painful rash.

After having introduced a chickenpox-vaccine some 25 years ago for infants and small children it was attempted to develop an adult-vaccine to protect against a reactivation of the virus. Short term follow-up of participants in studies of Herpes Zoster vaccines confirmed that it was effective for at least 5 years.

Now, a long-term follow-up of the first vaccine recipients has allowed investigators to estimate longer-term efficacy. Protection against shingles fell from 46% in year 7 to 14% in year 10 and was negligible in year eleven (Clin Infect Dis 2015 Mar 15; 60:910).

given at the age of 60 is unlikely to confer protection for the duration of the person’s life. Editorialists cautiously suggest rethinking public health recommendations and possibly endorsing a booster-vaccine about eight years after the first.

This seems to highlight a general phenomenon of vaccines: they are not the same as passing through the illness the ‘natural’ way.

Vaccines need to be renewed after some time because their protection runs out: vaccines have a ‘due date’ and this refers to every vaccine.

Whilst in school, the authorities will make sure that boosters are given and protection is kept up. But once we are 18 everybody seems to forget about it and therefore protection may be non-existent after some time.

As far as the shingles vaccine is concerned, it seems to me a rather doubtful improvement. I do not know, in the first place, why one needs to vaccinate against chickenpox. Is it only to enable modern parents to go to work as usual? Are sick and home-bound children a modern catastrophe?

Nowadays there is hardly any chickenpox amongst children.

If there was chickenpox, then the adults would receive a natural booster of their own body defenses and there would be no need (or possibility?) to vaccinate against shingles.

If you are an adult and you see a child with chickenpox: walk up to them and give them a kiss – your body’s defense will be invigorated and there will be no shingles.

If you are a parent and your child develops chickenpox: do pass it around the family and neighborhood and let the elders benefit by ‘vaccinating’ them against shingles.

Last month there was a case of diphtheria in Barcelona and it turns out the child was never vaccinated against it.

This is a completely different affair, because diphtheria is a potentially fatal infection and the affected child just about made it – chickenpox in contrast is not.

There are very sensible and necessary vaccines, but if the shingles vaccine should be listed amongst them is more than doubtful.

(News/Medical: Costa Tropical, Granada, Andalucia)

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