Chickenpox can be deadly with weakened immune systems

Dear Doctor: I recently read that more than 30 students at a school in North Carolina all got chickenpox during an outbreak. Growing up, I got chickenpox, too, before there was a vaccine. Is the vaccine really that necessary for kids? Like I said, I got chickenpox as a kid and turned out fine!

Dear Reader: It’s true that most children who develop chickenpox, a highly contagious disease caused by the varicella-zoster virus, go on to make a full recovery. Most often the virus causes an itchy rash that is often accompanied by a fever, headache, and some aches and pains.

However, that’s not the whole story. First, it’s important to note that from 2 to 6 percent of children who become infected with the chickenpox virus go on to develop complications as a result of the illness, some of them serious. These include pneumonia, bacterial infections, infections of the brain or the blood, and can lead to death. It’s when you look beyond the individual consequences and consider the community that chickenpox becomes a health threat far more widespread than an individual child stuck at home for a few weeks with a rash and a fever.

Those at risk of grave complications from a case of the chickenpox include infants under 12 months old, who are too young to receive the vaccine and whose immune systems are not yet fully developed. The same goes for the elderly, whose immune systems become less robust as they age. Also at risk are people whose immune systems are compromised, such as someone undergoing cancer treatment or someone who is HIV-positive.

For a pregnant woman, a case of chickenpox prior to her 20th week can result in health complications for her unborn baby, including scars, eye problems, malformed limbs, poor growth, small head size and delayed development. When the virus is contracted in the third trimester, there is a chance of problems with the baby’s central nervous system. The risk is small — just

1 to 2 percent — but with safe and effective vaccines available, it’s unnecessary. Again, it’s all about caring for one’s wider community.

When it comes to prevention, the Centers for Disease Control and Prevention recommends that children get an initial dose of chickenpox vaccine between the ages of 12 and 15 months. This should be followed by a second dose of the vaccine between the ages of

4 and 6 years. For people who are 13 or older and have either never been vaccinated, or have never had chickenpox, the recommendation is two doses of the vaccine, given a minimum of 28 days apart. It’s true that, despite receiving the vaccine, some people do go on to contract the disease. When that happens, symptoms are usually milder, meaning there are fewer blisters and often no fever. The illness will also typically be of shorter duration.

Most insurance plans will cover the chickenpox vaccine. If not, the Vaccines for Children Program offers help to individuals who qualify. For more information on this program, go to cdc.gov/features/vfcprogram. Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health. Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.