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    "When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov

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    Thursday, March 15, 2007

    A Pox On Us: The chickenpox vaccine - not as great as originally preached:

    Merck's chickenpox vaccine Varivax not only loses its effectiveness after a while, but it has also changed the profile of the disease in the population, U.S. researchers reported on Wednesday.

    The study confirmed what doctors widely knew -- that the vaccine's protection does not last long.

    And with fewer natural cases of the disease going around, unvaccinated children or children in whom the first dose of the vaccine fails to work have been catching the highly contagious disease later in life, when the risk of severe complications is greater, they said.

    This is frustrating. When the chickenpox vaccine was originally introduced and recommended, there was tremendous resistance from pediatricians and family physicians in the trenches- for these very reasons. There was the fear that the immunity would not be as good as that aquired through natural disease and that when the vaccine did wear off it would leave young adults vunerable to infection. Chickenpox is a pain to have as a child, but it's potentially life threatening to have it as an adult. Especially a pregnant adult. The experts, however, assured everyone that this was not a worry. The Japanese had been using it for years and it was effective there. Never mind that we don't live in Japan. And most of us aren't Japanese. And so, it became the standard of care to vaccinate against a childhood disease that was largely benign so we could avoid the rare death (usually in an immunocompromised child, and at a rate of 100 per year in the entire United States).

    What does this mean? It means we'll be giving boosters. Good for Merck. That doubles the demand for their vaccine. And if it turns out the booster's immunity fades with time, too, there will be another booster. It also means that we will probably see an increase in the incidence of chickenpox again after a steady decline over the past ten years. Which will be all the more reason to promote the booster.

    Selling the vaccine to the infectious disease community was truly a golden goose for Merck. It remains to be seen whether it was such a good thing for the rest of us.

    P.S. And don't you wonder how many of those infectious disease experts who preached the gospel of Varicella vaccination had financial ties of some sort to Merck? I do.

    posted by Sydney on 3/15/2007 11:48:00 PM 3 comments


    Is there any chance I can have my kids skip the chicken pox vaccine and just get a shot that will give them the real honest-to-goodness itchy, bumpy, stay out of school for a few days illness? Sounds like it would, in the long run, be a much better deal!

    The revelation of the vaccine's not being as good as originally advertised plays right into the hands of the anti-vax crowd, too.

    By Blogger Bob, at 8:05 AM  

    As a person who didn't get chicken pox as a kid and got it from his daughter when he was 40 years old, I can definitely support what Bob said.

    I also saw my son have a full-blown response to a DTP shot. It was not good, especially when the crusading emergency room doctor ignored our statements that his pediatrician had give us about possible reactions to the shot and diagnosed it as "chronically untreated pneumonia."

    But in retrospect, vaccines don't work unless everybody gets them. After all the flap with our son, I'd still have any kids of mine take the DPT shot.

    By Blogger Frank Borger, at 9:12 AM  

    I agree with medpundit about the obvious illogic of involving financial ties with public health decisions. I also think people have differing immune systems and will then have diffferent responses to vaccines, like Frank's son.

    FWIW, my father (deceased) was a physician so I got all my shots early and often while my husband had a German pedi who felt it was better for him to see if he got the benign infectious diseases like chickenpox first, and then of course she gave him a mumps vax when he reached adolescence. He's healthy as a horse.

    Then when I went on a Fulbright fellowship, I had another huge bunch of vax and now I'm autoimmune city and our son has many of the same autoimmune problems (plus cancer at 18 mos), and from what I'm reading about epigenetics, it's possible he inherited my dysregulated immune system.

    I'm not anti-vax (obviously, since I've vaccinated my kid with the 22 mandated vax'es and have 10000 myself) but I'm wondering if subverting all experiences of acquiring natural (and lifetime) immunity to any and all diseases via vaccination is the wisest thing, the fortunes of pharma execs aside...our kid also has severe MSG sensitivities and the Varviax is preserved in MSG...

    thanks for the discussion.

    By Blogger Green Fertility Marie, at 10:02 AM  

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