Many times during the past week, I wished my kids had been vaccinated

against chickenpox. It’s a miserable disease, and I hated to see them suffer

through it.

But overall, it’s a fairly mild disease when left to run its course among

children. Children with chickenpox rarely experience complications. Adults,

pregnant women, and immuno-suppressed people experience much more severe cases

and sometimes death. The chickenpox vaccine – Varivax – is not currently

"required." However, the American Academy of Pediatrics recommends

it, and it seems likely to follow in the wake of the other standard (and

currently required) vaccines against childhood illnesses – measles, mumps and

rubella.

So is there a problem? Should we not be grateful to Merck – the maker of

the vaccine – for saving us from this significant annoyance? Bringing a

layperson’s curiosity, parental concern for my own little ones soaking in

their oatmeal baths, and an inbred distrust of large pharmaceutical companies

and the FDA, I dipped into the available literature on the chickenpox vaccine

– a book from my library, numerous newspaper articles, medical journals, and

various web sites. Following are some of my concerns:

The vaccine is known to provide only temporary immunity, whereas actually

contracting the disease is known to provide life-long immunity. Providing

temporary immunity to children could drive chicken pox disease into the older

adult population where it can cause many more deaths and complications.

Merck – the pharmaceutical company that makes the chickenpox vaccine – has

been ordered by the FDA to follow vaccinated children for 15 years to better

understand how long they can expect to enjoy immunity. Clearly, individuals

need to be studied much longer – 80 years and more – to know whether the

vaccine’s immunity follows them into old age.

On the topic of longitudinal studies, how do we address the fact that

varicella and its human hosts have been evolving together for thousands of

years? Varicella developed the important knack of not killing off its host.

Instead, it just causes minor illness, spreads easily through groups of

children, and then lays dormant in the nerve cells until it (occasionally)

emerges decades later as shingles. This painful re-emergence of the varicella

virus makes the victim contagious for chickenpox. Anyone without immunity who

comes into contact with someone with shingles is likely to come away with

chickenpox. Thus, the ingenious varicella virus survives in its host,

reactivating itself decades later with the ability to infect a whole new

population of children.

In the process of fighting off chicken pox, children’s immune systems go

through the important exercise of identifying an unfriendly viral invader and

rallying the body’s resources to develop the proper antibodies in response.

Some doctors believe that childhood illnesses such as chickenpox provide a

training opportunity to the immune system, arming it with the

"knowledge" and "experience" of fighting off disease that

come in handy later on in life.

Furthermore, adult immune systems already equipped with chickenpox

antibodies, continue to get stronger and develop as they come into contact

with the varicella virus. Pediatricians who frequently see children with

chickenpox tend to have powerful antibodies to the disease, and, so, rarely

contract shingles later in life. During this last week and a half, in the

process of taking care of my virus-ridden children, my immune system geared up

against the disease, produced extra antibodies, and perhaps further refined

itself, equipping me with disease-fighting power.

Is there any value to this immune system training? I don’t know for sure.

The question has not been studied. When Merck tracks the effect of the

chickenpox vaccine, they do not ask what the cost to our immune system is. But

they do look at short-term financial trade-offs. The vaccine costs about $40

per child, the argument goes. The annual cost to "society" of

hospitalizations and lost work is estimated to be more than $400 million by

the Center for Disease Control in Atlanta. The obvious short-term financial

savings justify the vaccine.

Suddenly concerned with the practical aspects of a single mother’s life,

the head of the University of Florida vaccine study says, "If you have a

single mother with five children and one child comes down with chicken pox,

the mother either has to take off work or hire a baby sitter. When one child

comes down with chicken pox, two weeks later another one comes down with it

and then other cases may follow. A mother in such a family is literally out of

work or paying for a babysitter for a month or more."

True. It is no piece of cake to nurse any number of children through the

disease. And it’s even harder in this society – with so many uninsured, rare

instances of unpaid sick leave, and even rarer instances of paid time off to

care for sick family members. The vaccine could be quite practical to a single

mom of five children, but let’s not accept that as a solution. A quick-fix

vaccine should not direct our attention away from larger political goals and

supports for families – such as universal health care and adequate benefits.

Other deeper concerns could be addressed as well. While Merck lines its

pockets with profits through the sale of a vaccine that protects against one

isolated virus, who is addressing themselves to our immune system’s other

needs? Such as an adequate diet, cleaner air and water, access to such

stress-reducing resources as adequate housing, decent schools, fulfilling

jobs, etc.

There are lots of ways we need to take care of ourselves, our children, and

our single mothers. Varivax might indeed be a life-saving vaccine for some who

are most vulnerable to the virus, and it should be an option for people.

However, health protections should not be based only on short-term gains. It

may be that our immune systems are somewhat inconvenient to maintain: they

need the occasional annoying battle with a virus; they need bodies that are

adequately nourished and cared for. Nor should health protections be based on

the needs of a profit-driven economy that wants to prevent illness because

illness is inconvenient.