Why The UK Doesn’t Routinely Vaccinate For Chicken Pox

Why The UK Doesn’t Routinely Vaccinate For Chicken Pox

Chicken pox was once a childhood rite of passage – nothing to be feared, but definitely not the best fun you could have during the spring holidays.

Since the varicella vaccine has been included on the childhood vaccination program of many countries, chicken pox is now considered to be a disease to be avoided at all costs – except in the United Kingdom.

What is chicken pox, and why does the UK prefer to have natural rather than artificial immunity to this childhood disease?

Why Doesn’t The UK Vaccinate For Chickenpox?

Chicken pox is not part of the UK National Health Service childhood vaccination program.

The main reason for not vaccinating against this common childhood disease in the UK is to provide natural immunity to people at an early age, so they don’t contract the virus when they are older, which increases the risk of complications.

In the UK, chicken pox is extremely common during childhood. As a result, over 90% of adults have natural immunity to the virus. Most vaccination programs aim to have this percentage of the population vaccinated for varicella.

The varicella vaccine is available to those who have no immunity and who might come into contact with people who are particularly vulnerable to chicken pox. This includes healthcare workers who have no immunity to varicella, and those who come into close contact with immunocompromised people.

The NHS website states:

“There’s a worry that introducing chickenpox vaccination for all children could increase the risk of chickenpox and shingles in adults.

While chickenpox during childhood is unpleasant, the vast majority of children recover quickly and easily.

If a childhood chickenpox vaccination programme was introduced, people would not catch chickenpox as children because the infection would no longer circulate in areas where the majority of children had been vaccinated.”

But for those contracting chicken pox as adults, they are more likely to develop a more severe infection or a secondary complication. In pregnancy, there is an added risk of the infection harming the baby.

What Is Chicken Pox?

Chicken pox is caused by the varicella virus. Most healthy people who contract the virus will recover fully, without needing any special treatment. It’s highly contagious and outbreaks of the virus tend to occur in winter and spring.

Symptoms of chicken pox include:

  • Low grade fever (37-38 degrees Celcius)
  • Feeling low and lethargic
  • Small blisters surrounded by irregularly-shaped patches of inflamed skin. These first appear on the torso, and then spread to head and limbs. The rash can be mild to very profuse.

It’s important to note that people who have been vaccinated against chicken pox often have atypical symptoms of chicken pox. Spots might not appear on the torso first, and can be very mild in appearance.

What Causes Chicken Pox To Spread?

Once you have been exposed to chicken pox, and if you have been infected, it takes around 14 days for the rash to appear.  This is called the incubation period.

The virus is highly contagious and can be passed on by airborne droplets from the mouth or nose (via sneezing or coughing). The fluid in the blisters also contains the virus, and touching them can be a means of passing on the infection.

The contagion period usually starts 1-3 days before the rash appears, and continues until the blisters form scabs, which happens about 5-7 days after the rash first appears.

Is Chicken Pox Dangerous?

Complications from chicken pox can occur, but they are rare in healthy children. Those who are at risk for complications include:

  • Babies under 4 weeks old (one of the reasons why a newborn/mother hybernation period or babymoon is beneficial)
  • Pregnant women who have no immunity to varicella, due to their immune systems being lowered
  • Anyone over the age of 15
  • Anyone whose immune system is weakened, due to illness or medication, such as people with leukaemia, cancer or HIV/AIDS, and those taking immunosuppressive medications, or with long-term use of steroids.

Serious complications from chicken pox include:

  • Cellulitis: bacterial infection of the skin and tissues, which can lead to sepsis (infection of the bloodstream)
  • Pneumonia: infection and inflammation of the lungs
  • Encephalitis and cerebellar ataxia: inflammation of the brain (neurologic complications are believed to be around 1-3 cases in 10,000)
  • Bleeding disorders: rare but potentially fatal.

According to the NHS, around 5-14% of adults who contract chicken pox experience lung problems, including pneumonia. Smokers have a higher risk. However, the vast majority will make a full recovery from chicken pox.

Chicken Pox During Pregnancy

For those who contract chicken pox during pregnancy, the risk of complications for the baby is fortuntely very low, but it can occur. The NHS state that if you are infected with chickenpox during the first 28 weeks of your pregnancy, your unborn baby could develop a rare condition known as foetal varicella syndrome (FVS).

The risk of FVS in the first 12 weeks of pregnancy is less than 1%.
Between weeks 13 and 20, the risk is 2%.
From weeks 20 to 28, the risk is believed to be much lower than 1%.

How Do I Treat Chickenpox?

Antiviral medications can be prescribed for adults and teens who are at risk for more severe symptoms of chickenpox. This treatment is rarely given to otherwise healthy children.

The majority of chickenpox cases are mild. Treatment is aimed at relieving the discomfort of symptoms. Those with chickenpox should:

  • Have bed rest
  • Keep up fluids, especially if fever is present
  • Keep nails short, to avoid scratching blisters
  • Wear loose, light clothing to avoid irritating the rash; avoid heat and humidity
  • Take warm, but not hot, baths with baking soda or oatmeal added, to help relieve itchiness
  • Use creams and lotions, which help soothe and reduce itching

While fever is a common part of chicken pox, temperatures are usually mild (around 37-38 degrees). It’s often recommended to leave fever alone, unless a child is very distressed.

For more information, see our article Fever Phobia – What Is The Best Way To Treat A Fever?

Very Important Medication Information

Paracetamol is the preferred medication for treating symptoms of chickenpox.

Never give aspirin or ibuprofen to someone who has, or might have chickenpox.

  • Aspirin has been associated with a serious illness called Reyes syndrome, which causes swelling in the liver and brain.
  • Ibuprofen is an anti-inflammatory medication, often given for fever pain, and has been linked to severe secondary infections in children with chicken pox (which has been seen in the media lately).

Chickenpox is usually a mild disease, with symptoms that last for 1-2 weeks. Rest and treatment to relieve symptoms is the recommended course of action, unless the infected person is at risk for severe complications.

This article was written for informational purposes only – we do not advise for or against vaccination. What we do advise is for parents to research and make their own decisions. Be sure to seek advice from your care provider if you have any concerns about your child or family member.

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  1. Chicken pox: Very mild childhood illness. Introduced so that parents didn’t have to take time off work, not to improve the health of children. Shingles also occurs after vaccination. 20-25% of children develop “breakthrough” varicella within 5 years of vaccination. The vaccine is a live vaccine so the disease can develop after vaccination and spread to contacts, thus not protecting the herd. 1.9% post dose 1, 0.3% post dose 2 develop chicken pox. Widespread vaccination has also led to the increase of shingles in older populations, an epidemic of shingles is set to occur within a decade or so because of the lack of exogenous boosting. Repeat exposure boosts immunity (without causing disease recurrence) and lowers the risk of shingles.

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