Chickenpox Party: Developing Natural Varicella Immunity

http://www.mothering.com/articles/growing_child/child_health/chickenpox_party.html

By Brian Wimer, Jacquelyn L. Emm and Deren Bader
Issue 122, January/February 2004

"Whoopee!" When word got out that little George's cousin Natalie had
chickenpox, the playgroup phone tree lit up with the jubilant consensus: "
Chickenpox party!" George was there, as was Natalie, our "Patient Zero."
Jonah, Timothy, Sam, and Luka came with parents in tow, hoping to bring home
a lifelong party favor of double-stranded DNA herpesvirus.

Yes, it sounds cruel and unusual to subject one's child to a biological
sneak attack. But we weren't going blindly into this affair like Tupperware-
toting lemmings. We'd done our homework. On the kitchen table was a stack of
clinical studies citing the pros, cons, dos, and don'ts of catching wild
chickenpox in the company of friends.

Sharing sippy cups, whistles, and lollipops (sugar- and saccharine-free, of
course), the wee revelers romped and stomped and ran amok as microscopic
varicella viruses triggered the alarms of their mucous membranes,
manufacturing ideal antibodies for a lifetime of immunity.

Admittedly, we mommies and daddies were not caught in the mainstream with
this somewhat rebellious act. Today's conventional wisdom says to go with
the shot, which many parents do "to be on the safe side." But we at the
party were doing what we felt was safest, after weeding through the
propaganda and rhetoric about America 's latest "Red Scare": the deadly
scourge of chickenpox panic.

You've seen them: The spooky Merck & Co. ads with the crying rubber duck.
The statistics of children dying from chickenpox. The assurances of
vaccination safety. Slick. Even convincing, to some.

The leading edge of a new slew of mandatory policies is a recent decision
from an Illinois immunization advisory committee that has recommended that
chickenpox vaccinations be required for admission to Illinois schools-
against the advice of the state health board. Allegedly, five of the
committee's 18 members-and Illinois's governor, George Ryan, who vetoed a
bill that would have banned people with financial ties to pharmaceutical
companies from serving on the committee-had financial ties to Merck. 1
Conflict of interest or not, 29 states now require proof that children
entering daycare or school either have had chickenpox or have been
vaccinated against the disease.

Varivax, the varicella vaccine manufactured by Merck, was approved by the
FDA in 1995. The latest Centers for Disease Control (CDC) reports estimate
that 75 percent of the nation's children have been vaccinated with it. They
credit the vaccine with a significant statistical drop in the number of
chickenpox cases reported, and they have stacks of studies to back up their
claim. From 1987 to 1997, the reported national incidence of chickenpox
decreased 58 percent. 2 In fact, doctors are no longer required to report
chickenpox cases to local and state health departments-which just might have
some influence on optimistically low chickenpox statistics.

"The decrease from 1987 to 1997 corresponded with decreases in the number of
states reporting to NNDSS and the completeness of reporting," admits the
CDC. Areas reporting dropped from 46 states and DC in 1972 to 20 states in
1997. What declined was the reporting, not the incidence of chickenpox.
Today, the CDC actively watches only three US sites for varicella: West
Philadelphia , Pennsylvania ; Travis County, Texas; and Antelope Valley ,
Los Angeles County , California. 3

Two years after vaccine licensure, in the 14 states that maintained
continuous reporting of varicella, the incidence remained completely
unchanged, at 107.0 cases per 100,000 population. (The national incidence,
however, was reported by the CDC as dropping to 36.9. 4 )

While the CDC estimates the vaccine to be 86 percent effective in children,
a 2001 CDC study showed that that effectiveness might actually be as low as
40 percent. 5 But authorities at Maryland's Takoma Park Elementary School
might quarrel even with that. There, reportedly, 12 of the 16 cases of a
recent chickenpox outbreak involved children who had already been vaccinated
. 6

Moreover, the CDC's Jane Seward, MD; Karin Galil, MD, MPH; and Anne A.
Gershon, MD, director of the infectious disease division at Columbia
University College of Physicians and Surgeons, found further cause for
concern about the vaccine in a recent outbreak of chickenpox at a Concord,
New Hampshire daycare center. 7 It began with a child who had been
vaccinated, contradicting the theory that "breakthrough" cases-i.e.,
children who develop true chickenpox despite having been vaccinated-are not
contagious. Studies from Cedars-Sinai Medical Center also refute the idea
that vaccine-borne varicella is not contagious. 8-10

Nor, perhaps, is the vaccine as safe as advertised. A 2000 article in the
Journal of the American Medical Association disclosed a wealth of reports
made by doctors and parents to the Vaccine Adverse Event Reporting System (
VAERS). "This FDA report confirms our concern that the chickenpox vaccine
may be more reactive than anticipated in individuals with both known and
unknown biological high risk factors," said Barbara Loe Fisher, president of
the National Vaccine Information Center (NVIC). 11

Allowing for underreporting, the authors estimated that 4 percent of vaccine
-induced adverse reactions (about 1 in 33,000 doses) were serious, resulting
in shock, convulsions, encephalitis, thrombocytopenia, and 14 deaths. The
report adds 17 adverse events to the manufacturer's product label, including
secondary bacterial infections (cellulitis), secondary transmission (
infection of close contacts), and Guillain-Barré syndrome.

"This vaccine should not be mandated," said Fisher. "There are too many
questions about the true adverse event and efficacy profile of this
relatively new live virus vaccine." 12 Fisher's concerns are not theoretical
. Her son was left with multiple learning disabilities and attention deficit
disorder after a severe reaction to a DPT shot.

This is not to say that wild chickenpox is entirely benign. The CDC
estimates that the 4 million annual cases result in 11,000 hospitalizations
and 100 deaths every year. (Although deaths first became reportable to the
CDC only in 1999.) The risk of death from chickenpox complications in
healthy children is quite minimal. However, the CDC contends that chickenpox
is the leading "vaccine-preventable" killer of children, and many clinical
studies have been published attesting to the vaccine's safety and efficacy.

But, some vaccine critics say, the wild version has its advantages.
Allegedly, it produces much higher antibody levels than the vaccine, making
individuals less prone to developing shingles, the adult version of
chickenpox.

Getting chickenpox naturally works something like this: The virus enters the
body through the mucous membranes and the upper respiratory and
gastrointestinal tracts, giving the body time to work up a strong immune
response. Once the body's immune system has built an antibody for the virus,
the body will always build that same antibody on future contacts with the
virus. Theoretically, if the first encounter with chickenpox is through
vaccination, the resulting inferior antibody that the body develops is what
will be used whenever the body encounters chickenpox in the future.

Critics of vaccines say that catching the wild version can mean the
difference between temporary and lifelong immunity. According to Merck's
literature, "the duration of protection of Varivax is unknown at present."
Although studies in Japan report a 20-year vaccine duration, the CDC
theorizes that that immunity will wane if wild viruses are wiped out. 13

The danger here is illustrated well by Kristine M. Severyn, RPh, PhD, a
vaccine critic who has exposed drug-policy corruption in Ohio, Texas,
Illinois, the American Academy of Pediatrics (AAP), and the Advisory
Committee on Immunization Practices. 14 According to her studies, a
widespread national chickenpox vaccination program might shift the incidence
of chickenpox to adults, where the complication and death rate rise sharply
. 15 In America today, adults comprise only 2 percent of chickenpox cases,
but are responsible for 47.5 percent of deaths from chickenpox. 16

Dr. Arthur Lavin, a pediatrician at St. Luke's Medical Center in Cleveland ,
agrees, writing in The Lancet that routine varicella vaccination in healthy
children might pose a "grave danger of advancing the age of onset of
chickenpox into adulthood." 17

We were able to witness this firsthand. Luka's uncle Damir, 32, caught
chickenpox in the wake of our party. While all the kids had mild responses,
Damir got the worst case his doctor had ever seen: hundreds of lesions, even
in his mouth and down his throat; headache; and tender kidneys. Uncle Damir
couldn't sleep for two days. "Please, kill me," he joked as he staggered
about, coated head to toe in calamine lotion.

Painful or not, catching chickenpox may be necessary for health, claim some
clinicians. Internet medical celebrity Dr. Joseph Mercola theorizes that
since varicella virus is a member of the Human Herpes virus family (
herpesvirus 3 or HHV3), naturally acquired chickenpox may provide protection
against other herpesviruses that have been implicated in causing cancer,
Bell's Palsy, multiple sclerosis, AIDS, and chronic fatigue syndrome. 18

On the other side of the debate, Dr. Anne Gershon of Columbia University
recommends vaccinating children to help patients cope with leukemia. "
Because of the complexities involved in immunizing leukemic children, there
seems to be a greater interest in vaccinating healthy varicella-susceptible
individuals rather than leukemic children. If immunization with varicella
vaccine were recommended for all 15-month-old infants, most children who
become immunosuppressed because of development of leukemia would already
have been vaccinated against varicella-zoster virus." 19

Although technically correct, Gershon's opinion isn't taken seriously by
critics of vaccines. Vaccinating millions of healthy babies every year to
protect leukemic children against chickenpox seems a stretch, but it's the
kind of thinking that forms vaccination policy. The official reason behind
vaccinating infants for Hepatitis B was in case these tots grew up to engage
in high-risk sex or use IV drugs. Babies aren't statistically at risk for
Hepatitis B. They are vaccinated because they are "accessible."

Still, what about the 100 people who die of chickenpox each year? You
certainly wouldn't want your child to be one of them. "Sadly, about 7,400
kids end up in the hospital each year because of problems due to chickenpox.
. . . And tragically, about forty children lose their lives," warns a Merck
Varivax advertisement. But, a skeptic would ask, are those numbers accurate
? Not entirely. Even Merck's clinical papers characterize chickenpox as a "
benign, self-limiting disease." Technically speaking, people die not from
chickenpox, but from complications, such as pneumonia, staph infection,
meningitis, and encephalitis.

Moreover, some investigators suggest that modern medicine is to blame. After
reviewing the medical records of several children who had allegedly died of
chickenpox, Gary Krasner, director of the Coalition for Informed Choice, an
anti-vaccine advocacy group, concludes: "Nearly all of these deaths were a
result of standard medical care. Physicians would treat the children with
antibiotics, analgesics, or steroidal medications as their condition grew
progressively worse. . . . The doctors responded to each new symptom with
yet another drug, until the children died." 20 Here's one such report:

"On February 28, 1997 , a previously healthy, unvaccinated 21-month-old boy
developed a typical varicella rash. . . . On March 1, he was taken to a
local emergency department (ED) with a high fever and was started on oral
acetaminophen [Tylenol] and diphenhydramine [an antihistamine]. On March 3,
his primary-care physician prescribed oral acyclovir [an antiviral]. On
March 4, his mother noted a new petechial-like rash. . . . [H]is primary-
care physician noted lethargy, a purpuric rash, and poor perfusion [pulse].
He was transferred to a local ED. Fluid resuscitation and intravenous
ceftriaxone [an antibiotic] were initiated, but the child continued to
deteriorate rapidly, requiring intubation, mechanical ventilation, and
inotropic [heart] support with dopamine [a morphine-like neurotransmitter].
. . . [H]e suffered cardiac arrest and died. The death was attributed to
varicella." 21 (our italics)

What's interesting about this case is that it and two others were specific
examples published in a 1998 issue of the CDC's Morbidity and Mortality
Weekly to promote childhood vaccinations. 22 The cases were from 1997 in
Texas and Iowa . It's unclear why these deaths were highlighted out of the
alleged 100 chickenpox deaths that year. However, it's crucial to know that
the second child, an asthmatic on the steroid Prednisone, was also given an
antipyretic (probably aspirin or acetaminophen), and eventually developed
and died from Group A strep (GAS).

The third child was treated with five antibiotics: one "unspecified," then
methicillin and ceftriaxone, until he developed penicillin-resistant
Staphylococcus. He was then put on nafcillin and gentamicin. Antibiotics can
complicate varicella. First off, varicella is a virus, against which
antibiotics are useless. Antibiotics may be necessary in advanced cases
against secondary bacterial infections, but, Gary Krasner says, they impair
the immune system-and the healing process, since they kill the good bacteria
along with the bad. "After cells have been damaged, it is important for
bacteria, acting as scavengers, to attack and devour the weakened, injured
and dead cells. Otherwise, these dead cells would become accumulated toxic
waste themselves." 23

Antibiotics were recently found to increase the risk of hemolytic-uremic
syndrome when used for treatment of children with E. coli. 24 Whether or not
they also complicate varicella remains unknown. Another issue to consider
is that overuse of antibiotics has led to antibiotic-resistant bacteria. Of
note are the relative prevalence of antibiotic-resistant streptococcus
pneumoniae in daycare centers, and the relative prevalence of streptococcus
pneumoniae in varicella complications and deaths. 25

Krasner's theories are partially substantiated by a 1999 paper by Benjamin
Estrada, MD, of the University of South Alabama . Estrada reports that
nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, acetaminophen
, naproxin, and ibuprofen (Motrin, Advil, Nuprin) promote such GAS
infections as necrotizing fasciitis (NF) and streptococcal toxic-shock
syndrome-some of the major complications of varicella. The correspondence is
significant: doctors routinely prescribe NSAIDs to lessen the aches and
itching of chickenpox. 26

Estrada cites several studies. One found that development of invasive GAS
infection was 8.3 times more likely in patients who used ibuprofen during
the first five days after the onset of chickenpox. Another, focusing on NF,
found that ibuprofen use led to twice as many hospitalizations as in control
groups. 27-29

But with dangerous regularity, physicians prescribe NSAIDs such as ibuprofen
to children with chickenpox. Take online Parents Place/Parent Soup "expert"
Robert Steele, MD, for example. His column was awarded Best of the
Pediatric Internet by the AAP, and Sesame Street magazine calls it one of
the Best Health Sites for Parents. Yet Steele happily promotes ibuprofen for
"fever control" during chickenpox because it's free of "sticky theoretical
considerations." 30 Theoretical? Estrada would differ.

One other varicella-linked pharmacological danger is Reye's Syndrome, a life
-threatening condition that causes liver failure and swelling of the brain.
Epidemiological research links Reye's Syndrome and the use of aspirin for
treating the symptoms (usually fever) of chickenpox. 31 Moreover, according
to the National Reye's Syndrome Foundation, "An epidemic of flu or
chickenpox is commonly followed by an increase in the number of cases of
Reye's Syndrome." 32 Symptoms include irregular breathing and lethargy, two
symptoms that often appear in case studies of varicella deaths. Reye's
Syndrome is often misdiagnosed as encephalitis or meningitis, two
complications that often appear in case studies of varicella deaths. Is it
possible that aspirin is making a benign virus a killer?

Then there's the "death by misadventure" case of Lexie McConnell, a nine-
year-old girl from England . She, too, died of chickenpox, but the coroner's
inquest directly linked her death to the steroid Prednisone. She had been
prescribed the potent anti-inflammatory drug for a pre-existing eye
infection. Her parents have since collected a 20,000-signature petition
calling for an inquiry into corticosteroid prescription in Britain , a
motion that has reached as high as the European Parliament. 33

The VAERS post-licensure study also faulted medical practitioners for
contributing to varicella complications by simply administering the vaccine.
"Pregnant women occasionally received varicella vaccine through confusion
with varicella zoster immunoglobulin," 34 According to JAMA.

Besides these medical mishaps, there is another pattern in chickenpox-
related fatalities: pre-existing medical conditions. Vaccine proponents
often refer to a Reuters report that cites six Florida deaths in 1998 linked
to chickenpox. "Since all six were good candidates for the vaccine, these
deaths could have been prevented." A closer examination of the cases reveals
that only two of the deaths were of children. One, an asthmatic, had been
on steroids and died on a respirator. The other had leukemia and had been on
immunosuppressive therapy since receiving a bone-marrow transplant. Of the
adults, one was also an asthmatic on steroids (Prednisone again); another
had diabetes, asthma, and cirrhosis of the liver. 35 Also interesting to
note is that two of the adults who died were born and raised in Cuba.
Because varicella is susceptible to heat, it is less easily communicated in
tropical areas. People from the tropics are less likely to acquire immunity
in childhood, and thus have higher rates of susceptibility as adults.

But we at the party knew all that. Our children were all healthy. None had
asthma or leukemia (that we knew of), and no one was on steroids. Nor were
we planning to give anyone Tylenol, aspirin, or NSAIDS of any kind. It was
our belief that, given the correct circumstances, what we were doing was
acceptably safe, rationally prudent, and would give our children a lifetime
of immunity to a disease that could be dangerous in adulthood.

Yes, we all lost a night or two of sleep with a fussy child-the vaccine
reportedly results in a milder version of chickenpox. But we felt those
missed hours were worth the preservation of our children's health and well-
being. Besides, they don't give out party hats at the doctor's office.

NOTES
1. Jim Ritter, "Ties to Drug Company Raise Vaccine Questions," Chicago Sun
Times, 27 January 2002 .
2. "Evaluation of Varicella Reporting to the National Notifiable Disease
Surveillance System: United States, 1972-1997," MMWR 48, no. 3 ( 29 January
1999 ): 55-58.
3. Ibid.
4. Ibid.
5. "Low Varicella Vaccine Effectiveness Identified at Day Care Center ,"
Reuters Health, 19 December 2001 .
6. Avram Goldstein, "Chickenpox Cases Raise Questions," Washington Post, 2
February 2001 : B08.
7. "Chickenpox Vaccine Doesn't Ensure Protection," Reuters Health, 11
December 2002 .
8. Victoria Stagg Elliott, "Chickenpox Vaccine's Staying Power Questioned,"
www.amednews.com , 20 January 2003 .
9. P. A. Brunell, T. Argaw, "Chickenpox Attributable to a Vaccine Virus
Contracted from a Vaccinee with Zoster," Pediatrics 106, no. 2 (August 2000)
: e28.
10. R. P. Wise et al., "Postlicensure Safety Surveillance for Varicella
Vaccine," Journal of the American Medical Association 284 (2000): 1271-1279.
11. Barbara Loe Fisher, NVIC Press Release, 13 September 2000 .
12. Ibid.
13. Committee on Infectious Diseases, " American Academy of Pediatrics:
Varicella Vaccine Update," Pediatrics 105 (January 2000): 1, 136-141.
14. K. M. Severyn, RPh, PhD, "Profits, Not Science, Drive Vaccine Mandates,"
Medical Sentinel 5, no. 5 (2000): 173-174.
15. S. L. Thomas et al., "Contacts with Varicella or with Children and
Protection Against Herpes Zoster in Adults: A Case-Control Study," The
Lancet 360, no. 9334 (2002): 678-682.
16. K. M. Severyn, RPh, PhD, "Chickenpox Vaccine: Does Everyone Need It?."
Ohio Parents for Vaccine Safety Newsletter (Autumn 1994).
17. Arthur Lavin , MD , letter to the editor, The Lancet 343, no. 8909 (1994
): 1363.
18. www.mercola.com/2001/feb/14/chicken_pox_vaccine.htm .
19. Anne A. Gershon, MD, "Varicella Vaccine: Still at the Crossroads,"
Pediatrics 90 (1992): 144-148.
20. Gary Krasner, "Chickenpox: Why Do Children Die?," Well Beings Newsletter
(January 1999).
21. "Varicella-Related Deaths Among Children: United States , 1997," MMWR 47
, no. 18 ( 15 May 1998 ): 365-368.
22. Ibid.
23. See Note 20.
24. L. B. Zimmerhackl, "E. coli, Antibiotics, and the Hemolytic-Uremic
Syndrome," New England Journal of Medicine 342, no. 26 ( 29 June 2000 ):
1990-1991.
25. L. A. Mandell et al., "The Battle Against Emerging Antibiotic Resistance
: Should Fluoroquinolones Be Used to Treat Children?," Clinical Infectious
Diseases 35 (2002): 721-726.
26. Benjamin Estrada , MD , "Varicella and GAS: Do NSAIDs Fuel the Fire?"
Infect Med 16, no. 5 (1999): 307.
27. D. M. Zerr et al., "A Case-Control Study of Necrotizing Fasciitis During
Primary Varicella," Pediatrics 103 (1999): 783-790.
28. T. Brogan et al., "Group A Streptococcal Necrotizing Fasciitis
Complicating Primary Varicella: A Series of Fourteen Patients," Pediatric
Infectious Disease Journal 14 (1995): 588-594.
29. C. L. Peterson et al., "Risk Factor for Invasive Group A Streptococcal
Infections in Children with Varicella: A Case-Control Study," Pediatric
Infectious Disease Journal 15 (1996): 151-156.
30. www.parentsoup.com/experts/ped/qas/0,,200532_417014,00.html?arrivalSA=1&
arrival_freqCap=1&pba=adid=6283455 .
31. "Reye's Syndrome-Ohio, Michigan ," MMWR 46, no.
32 ( 15 August 1997 ): 750-755. 32. www.reyessyndrome.org/what.htm .
33. "Traumatised Parents Agree Payout," BBC News, 23 June 1999 , 01:21 GMT
02:21 UK .
34. See Note 10.
35. "Varicella-Related Deaths-Florida, 1998," MMWR 48, no. 18 ( 14 May 1999
): 379-381.

For more information about chickenpox, see the following past issues of
Mothering: "The Chickenpox Vaccine," no. 79 and "Putting Up with Chickenpox,
" no.70.

Brian Wimer is a freelance writer living in Charlottesville, Virginia, where
Deren Bader, CPM, MPH, assists births (most recently, of Brian's daughter
Maya-an at-home VBAC, no less); and where Jacquelyn L. Emm, MPH, former
director of the Breast Cancer Early Detection Program for Santa Clara County
in San Jose, California, raises two healthy boys, George (3) and Sam (1),
who have both had chickenpox.