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<< Previous   of   Next >>   ADVERTISEMENT   CONTACT THE HERALD Melanie Munk, Features Editor munk@heraldnet.com   Published: Tuesday, August 14, 2007 Double-dose of chickenpox shots good idea for many By Dr. Elizabeth Smoots, Herald Columnist Life has changed a lot in the 12 years since the advent of the chickenpox shot: Most children no longer endure blistering sores in all sorts of uncomfortable places, along with high fevers, I'm happy to say. And the average parent doesn't miss a week of work for each child in the family, staying home to prepare oatmeal baths and slather on calamine lotion. Good grief - what a relief! All together, some 3.5 million kids aren't required to itch and scratch their way through chickenpox in the United States each year, thanks to routine vaccination against the infectious disease. The vaccine may also help prevent most of the 9,000 hospitalizations and 90 deaths from complications of chickenpox that used to occur every year. Yet, outbreaks of chickenpox, also known as varicella, keep cropping up in school-aged children. Unvaccinated kids are the most susceptible. But even among the vaccinated children in an outbreak, up to a fifth may still develop a milder, yet contagious, form of chickenpox. It seems that just one dose of the childhood varicella shot isn't enough to hold sway over these insidious and highly infectious epidemics. Is there anything else that will? New recommendations A double dose of the vaccine during childhood may be the answer, according to the Advisory Committee on Immunization Practices along with the American Academy of Pediatrics and the American Academy of Family Physicians. The immunization committee advises the Centers for Disease Control and Prevention about all vaccines given in the United States. This year, all three organizations updated their recommendations to include two shots for chickenpox during the early childhood years. The first dose should be given at age 12 to 15 months as before. And the newly recommended second dose should be administered at age 4 to 6 years, or about the time of entering kindergarten or first grade. The organizations also advise older children, teenagers and adults who previously received only one varicella shot to go ahead and get a booster. For those who are still unvaccinated, it's not too late to get the two injections - given over a few months' time - to gain the full protection. Varicella information Two forms of the vaccine are available. Varivax, made by Merck, contains only the chickenpox virus. ProQuad, also made by Merck, provides protection against measles, mumps and rubella in addition to varicella. The combination vaccine reduces the number of injections routinely required in children who get the recommended shots at age of 12 to 15 months and again at age 4 to 6 years. The chickenpox portion of the vaccines is generally well tolerated. Soreness, redness or swelling at the injection site can occur. About 15 percent of vaccine recipients develop a fever. In addition, there is a slight chance of a chickenpox-like rash, which may occur up to eight weeks after an injection. Certain people need to avoid the chickenpox shot altogether. The vaccine, which is prepared from a weakened form of live virus, is not recommended for pregnant women or people with impaired immunity. Infants younger than 12 months and people who are acutely ill are better off delaying the vaccine. Overall, the vaccine usually does the trick for most who get it. A second dose of the vaccine increases the effectiveness against severe disease from about 94 percent to 98 percent, according to one study. Consult your doctor about the children, teens and adults in your family who are not fully protected against chickenpox. For more information: Centers for Disease Control, www.cdc.gov. Contact Dr. Elizabeth Smoots, a board-certified family physician and Fellow of the American Academy of Family Physicians, at doctor@practicalprevention. com. Her columns are not intended as a substitute for medical advice or treatment. Before adhering to any recommendations in this column consult your health care provider. 2007 Elizabeth S. Smoots

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