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Several studies have shown that people vaccinated against varicella had antibodies for at least 10 to 20 years after vaccination. But, these studies were done before the vaccine was widely used and when infection with wild-type varicella was still very common."
That cite was from 2012. There has been no change in chickenpox vaccine policy since then. The vaccine has only been licensed in the US since 1995 (1987 in Japan). We won't know for many years just how long it will last. But there's no evidence that it's failing.
Several studies have shown that people vaccinated against varicella had antibodies for at least 10 to 20 years after vaccination. But, these studies were done before the vaccine was widely used and when infection with wild-type varicella was still very common."
That cite was from 2012. There has been no change in chickenpox vaccine policy since then. The vaccine has only been licensed in the US since 1995 (1987 in Japan). We won't know for many years just how long it will last. But there's no evidence that it's failing.
Thanks. I've actually looked at that page before I was hoping Larry would take the time to look it up for himself. His claim that the varicella vaccine confers lifetime immunity is at best, an exaggeration. The truth is that no one knows how long it lasts. We do know that the efficacy rate declines from year one (97%) post vaccination to year two(86%) where it remains stable through the 8th year (81% to 86%). After that we just don't know.
^^In 50 years, we might have the answer to that. But for now, we can say "long term" with assurance. If immunity does start to wane, a booster would be necessary.
I would not recommend forgoing the vaccine. The chance that you'll never get chickenpox in childhood is quite high, and going into adulthood w/o chickenpox immunity is not a good idea. If you get the disease, you'll be sicker. There's also the chance in adulthood of occupational exposure such as working in a pediatric office or any kind of health care where you might be exposed to people with shingles (who can transmit chickenpox to the non-immune).
^^In 50 years, we might have the answer to that. But for now, we can say "long term" with assurance. If immunity does start to wane, a booster would be necessary.
I would not recommend forgoing the vaccine. The chance that you'll never get chickenpox in childhood is quite high, and going into adulthood w/o chickenpox immunity is not a good idea. If you get the disease, you'll be sicker. There's also the chance in adulthood of occupational exposure such as working in a pediatric office or any kind of health care where you might be exposed to people with shingles (who can transmit chickenpox to the non-immune).
That's a new problem that the vaccine created. People used to get chicken pox in childhood and for the vast majority it was not a big deal. Now people who are unvaccinated are faced with the much more dangerous possibility of getting it in adulthood. If the immunity acquired from the vaccine turns out to not be as long term as people hope, those adults may also face chicken pox as adults. That is scary.
Of course though the solution to the problem that the vaccine created will always be more and more vaccines.
I'd rather have had the vaccine and have less chance of getting shingles than have had chicken pox. Luckily I was too young to remember what it was like but I remember my best friend was miserable with it. And my brother has had shingles three times and he's only 30!
Infants too young to be vaccinated are generally exempt from the vaccine requirements that some countries have for entry. Flying, in general, is considered safe for infants, but as always, one has to be concerned about exposure to disease with unimmunized or partially immunized infants.
Just want to add that infants as young as 6 months old can get the measles vaccine if they are traveling to places where there is a risk of coming in contact with the disease. That dose is in addition to the other recommended doses, since infants that young do not respond optimally to the vaccine.
I am a proponent of at least requiring measles vaccination to get into the country, both for returning American citizens and foreign travelers.
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Originally Posted by MissTerri
Please provide a source for this.
Quote:
Originally Posted by MissTerri
Thanks. I've actually looked at that page before I was hoping Larry would take the time to look it up for himself. His claim that the varicella vaccine confers lifetime immunity is at best, an exaggeration. The truth is that no one knows how long it lasts. We do know that the efficacy rate declines from year one (97%) post vaccination to year two(86%) where it remains stable through the 8th year (81% to 86%). After that we just don't know.
"How long does the immunity last? Since the VV was licensed for use in the United States in 1995, it is too early in our country to tell the long-term benefits. Yet, pre-licensure clinical trials in the U.S. have indicated protection for at least thirteen years, and studies in Japan have shown protection for at least twenty years.
I remember having this concern with other “live” vaccines (e.g. measles and German measles) when they were first introduced. Yet, studies have shown that immunity to these vaccines is life-long. Worse case scenario is that a VV [varicella vaccine] booster shot may be needed in adolescence or adulthood, although history with the measles vaccines have shown this not to be necessary. (Even though some schools insist on a second MMR injection before school entry, this policy is not because the immunity has worn off, but because in a tiny percentage of children the original vaccination didn’t take)."
"No child developed varicella after a second dose. HZ [herpes zoster] cases were mild, and rates were lower in the cohort of vaccinated children than in unvaccinated children during the prevaccine era (relative risk: 0.61 [95% confidence interval: 0.43–0.89])."
"CONCLUSIONS: This study confirmed that varicella vaccine is effective at preventing chicken pox, with no waning noted over a 14-year period. One dose provided excellent protection against moderate to severe disease, and most cases occurred shortly after the cohort was vaccinated. The study data also suggest that varicella vaccination may reduce the risks of HZ in vaccinated children."
Since the vaccine has not been in use for a period corresponding to a lifetime, obviously no one can yet say for sure that protection is lifelong. To this point, however, there is no indication that routine boosters are needed for adults. With the approval of the shingles vaccine, protection lasting until age 50 would get an individual to that point. The early clinical trials were done in Japan in the 1970s, so the vaccine has been in use for 40 years. Long term follow up of the first people to get the vaccine should shed light on the subject.
The bottom line is that protection from the varicella vaccine is projected to be lifelong, such as with other live virus vaccines.
Quote:
Originally Posted by MissTerri
That's a new problem that the vaccine created. People used to get chicken pox in childhood and for the vast majority it was not a big deal. Now people who are unvaccinated are faced with the much more dangerous possibility of getting it in adulthood. If the immunity acquired from the vaccine turns out to not be as long term as people hope, those adults may also face chicken pox as adults. That is scary.
Of course though the solution to the problem that the vaccine created will always be more and more vaccines.
High vaccination rates will produce herd immunity, reducing the risk that susceptible adults will be exposed.
When the vaccine was introduced, the incidence of chickenpox in unvaccinated adults went down.
"A newly released study shows that the number of the chickenpox cases in the U.S. has significantly dropped since the chickenpox vaccine became available in 1995. This decline was seen even among the largely unvaccinated adult population, a trend that may be explained by the theory of herd immunity."
Yes, adults who have not been vaccinated should consider taking the vaccine. Since many people had it and had few or no symptoms, a titer can be done first.
Let's see what Dr. Sears has to say, from the link above:
"Studies show that the great majority of adults who don’t remember ever having had chickenpox actually are immune to the disease. (Yet, those studies were done in the pre- vaccine days when nearly all persons were exposed at some time in their life to chickenpox and developed immunity to the disease without developing noticeable signs and symptoms of chickenpox.) If as a teen or adult you don’t remember ever having had chickenpox, it would be wise to ask your doctor about having a blood test (called a varicella titer) to see if you are immune to the disease. If you aren’t, you should consider getting the VV vaccine. Around 70 to 90 percent of persons over eighteen years of age who don’t remember ever having had chickenpox will be immune, so it is cost-effective to have a varicella titer, which is much less expensive than two doses of the vaccine. Yet, if you don’t want to have the blood test and would rather get the vaccine, there is no increased severity of reactions in already immunized persons."
Last edited by suzy_q2010; 04-30-2016 at 09:46 AM..
I'd rather have had the vaccine and have less chance of getting shingles than have had chicken pox. Luckily I was too young to remember what it was like but I remember my best friend was miserable with it. And my brother has had shingles three times and he's only 30!
You can still get shingles after having the chicken pox vaccine. Having chicken pox or the varicella vaccine is what makes you susceptible to getting shingles later in life. The idea that getting the vaccine vs the natural infection makes you less likely to get shingles or a milder version is pure speculation.
Some studies support the hypothesis that being exposed to chicken pox after having it or after having the vaccine is something that helps stave of shingles via exogenous boost. That no longer happens much since chicken pox is so rare people don't get the benefit of re-exposure The "solution" will just be more and more vaccines.
Quote:
Overall, 8 studies supported the exogenous boosting hypothesis, whereas 3 studies did not and 2 remained inconclusive in regard to the exogenous boosting hypothesis.
Just want to add that infants as young as 6 months old can get the measles vaccine if they are traveling to places where there is a risk of coming in contact with the disease. That dose is in addition to the other recommended doses, since infants that young do not respond optimally to the vaccine.
I am a proponent of at least requiring measles vaccination to get into the country, both for returning American citizens and foreign travelers.
"How long does the immunity last? Since the VV was licensed for use in the United States in 1995, it is too early in our country to tell the long-term benefits. Yet, pre-licensure clinical trials in the U.S. have indicated protection for at least thirteen years, and studies in Japan have shown protection for at least twenty years.
I remember having this concern with other “live” vaccines (e.g. measles and German measles) when they were first introduced. Yet, studies have shown that immunity to these vaccines is life-long. Worse case scenario is that a VV [varicella vaccine] booster shot may be needed in adolescence or adulthood, although history with the measles vaccines have shown this not to be necessary. (Even though some schools insist on a second MMR injection before school entry, this policy is not because the immunity has worn off, but because in a tiny percentage of children the original vaccination didn’t take)."
"No child developed varicella after a second dose. HZ [herpes zoster] cases were mild, and rates were lower in the cohort of vaccinated children than in unvaccinated children during the prevaccine era (relative risk: 0.61 [95% confidence interval: 0.43–0.89])."
"CONCLUSIONS: This study confirmed that varicella vaccine is effective at preventing chicken pox, with no waning noted over a 14-year period. One dose provided excellent protection against moderate to severe disease, and most cases occurred shortly after the cohort was vaccinated. The study data also suggest that varicella vaccination may reduce the risks of HZ in vaccinated children."
Since the vaccine has not been in use for a period corresponding to a lifetime, obviously no one can yet say for sure that protection is lifelong. To this point, however, there is no indication that routine boosters are needed for adults. With the approval of the shingles vaccine, protection lasting until age 50 would get an individual to that point. The early clinical trials were done in Japan in the 1970s, so the vaccine has been in use for 40 years. Long term follow up of the first people to get the vaccine should shed light on the subject.
The bottom line is that protection from the varicella vaccine is projected to be lifelong, such as with other live virus vaccines.
Yes, correct about giving measles vaccine at 6 mo for travel to endemic areas. That dose then doesn't count for the series; protection doesn't last long in babies.
Sears' understanding of the second dose of MMR is a bit twisted. It's not the schools "insisting", it's the CDC/ACIP recommendation. His reasoning is correct.
Our practice saw a kid who got chickenpox after two doses of vaccines. I don't know if they reported it. It was a pretty mild case, but he did have a fairly good rash, no pustules though.
You can still get shingles after having the chicken pox vaccine. Having chicken pox or the varicella vaccine is what makes you susceptible to getting shingles later in life. The idea that getting the vaccine vs the natural infection makes you less likely to get shingles or a milder version is pure speculation.
Some studies support the hypothesis that being exposed to chicken pox after having it or after having the vaccine is something that helps stave of shingles via exogenous boost. That no longer happens much since chicken pox is so rare people don't get the benefit of re-exposure The "solution" will just be more and more vaccines.
Natsku is correct that you have less chance of getting shingles after the vax than after natural disease. Can the Chickenpox Vaccine Cause Shingles Later in Life? Now I could spend all day looking for a study, but maybe you could take the word of an expert on infections diseases. It's not "pure speculation".
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