I think there's an ethical problem with a treatment that has very limited benefit for the person treated, rather than society at large -- IIRC, the HPV viruses haven't been shown to cause cancer in men. At which point we're asking boys to be vaccinated only to protect their future partners, with no significant direct health benefit to them.
I don't think this should be insurmountable: I think vaccination of boys too is a good idea for the obvious public health reasons. But you can see there's an issue there.
Absolutely. If, in 10yrs, it is shown to be safe and effective in wide circulation, I'd say spray it through 5th grade classrooms throughout the land.
why is the HPV vaccine only marketed to young girls
It isn't clear yet whether it works in men. The really frustrating part are the parents who say their daughter doesn't need it because she's not having sex yet. Right, geniuses. You're SUPPOSED to get it before you start having sex.
I don't know, living in an immune herd certainly could be seen be a benefit to an individual cow.
Is there a cost-benefit problem? Men can get side effects but not ovarian cancer?
I think there's an ethical problem with a treatment that has very limited benefit for the person treated, rather than society at large -- IIRC, the HPV viruses haven't been shown to cause cancer in men.
What's the ethical problem? It's never the law to vaccinate your kid, why wouldn't this be good public policy?
4 answers my question for all practical purposes, I suppose.
Right, geniuses. You're SUPPOSED to get it before you start having sex.
Warts?
Or rather, the FDA hasn't yet approved Gardasil for use in men. The data showing that it's effective in men was only just published in the past couple of months and has very recently been submitted to the FDA.
Is there a cost-benefit problem? Men can get side effects but not ovarian cancer?
If the side effects weren't outrageous, I'd still argue that everyone benefits when women don't get cervical cancer.
7: Think of the individual doctor. "Bobby, I'd like to stick a needle in your arm. There may be side effects, and you personally won't receive any health benefit from it. But it will do other people, not you, some good. I think you should do it." I think there's a medical ethics problem with a doctor urging self-sacrifice on his patients.
(I may have my facts garbled -- maybe it'll be shown that the vaccine keeps men from getting warts, which would solve the ethical problem.)
Also, HPV warts on the anus lead to cancer at rates approaching cervical warts, and that risk is obviously not gender-specific.
It's marketed up till age 27. It's being pushed towards young girls because, as apo notes, better to get the immunity before one starts being sexually active.
As far as parents not wanting to vaccinate their daughters, I'm sure part of it is stupid slut shaming, but part of it seems to be that it's a vaccine targeted at a virus that has a small chance of causing cervical cancer, and that getting the vaccine doesn't mean you won't get another kind of cervical cancer anyway. This makes it a little bit immune to the normal herd immunity vaccine rationale; it's not smallpox.
It's also new and very expensive. Which is probably the other part of it.
13: Why not: "Bobby, here's a shot that will protect you from a couple common strains of HPV. But the real benefit is that you'll be protecting your future wife from cervical cancer."
The Great Thimerosal Swindle makes me so damn mad. I have had exactly the sorts of conversation with reasonable, thoughtful people (who, thank god, are vaccinating their own kids) saying "well, there's good points on both sides." Noooo!
I'm planing on scheduling Iris for the HPV virus a week before she turns 18. I'm sure she'll appreciate that I'm endorsing Senior Prom Sex.
No one we're close to has bought into the vaccine/autism thing, but I think AB has conversed with a few acquaintances on the topic. Freaks.
I'm planing on scheduling Iris for the HPV virus a week before she turns 18
Umm, how exactly are you planning on administering the virus?
Also, HPV warts on the anus lead to cancer at rates approaching cervical warts...
"And now your precious little girl can preserve her virginity without fear."
16: Same problem. The wife is not-the-doctor's-patient. I think doctors have a real ethical problem with advising their-patient to do anything for the benefit of not-their-patient.
I'm spouting off about medical ethics, though, and I'm not sure. Who's a doctor around here? Read? Anyone else?
19: I know a guy who works for cherap, JRoth.
16 - "or your future male civil partner from cancer fo the arse".
I assume it has a lot to do with it being twice as expensive to give it to everyone. Rubella is a vaccine already given pretty much entirely for other people's benefit.
If the side effects weren't outrageous, I'd still argue that everyone benefits when women don't get cervical cancer.
I'd agree, but as LB argues, I'm not sure medical ethics allows this. Of course, if Apo is correct this would be obviated.
No one we're close to has bought into the vaccine/autism thing
We know just one couple who declined to vaccinate because of that. We also know just one couple whose child was recently diagnosed with autism. Same couple.
It's also new and very expensive. Which is probably the other part of it.
Aren't there also questions about how long Gardasil lasts? I think they're unsure whether one shot at a young age will do it or if you have to get a booster shot at some point.
Certainly if I give my sex partners cancer and they die, it doesn't necessarily harm me in any way, for example if I never really liked them anyway, or no longer know them by the time they get sick, or never knew them in the first place. It's a very rare case indeed when the male is affected in any way.
So long as he assiduously avoids relationships.
Slightly OT, I really wanted to get the HPV vaccine and thought taht it could be useful, because I haven't had many partners, but I'm too old to have insurance pay for it.
Back OT, I had never gotten a Hepatitis B vaccine, so I went to a clinic that was doing outreach to gay men where I got both Hep B and A for free. I asked the nurse about the HPV vaccine, and she said taht she thought boys ought to get it too. That clinic or my regular PCP would probably be glad to give me teh vaccine, but I'd have to pay out of pocket which was something like $300.
Of course, if Apo is correct this would be obviated.
Not just the anus. HPV is also linked to cancers of the mouth and throat.
Aren't there also questions about how long Gardasil lasts?
Necessarily so, given that it's only existed for a few years.
I'd still argue that everyone benefits when women don't get cervical cancer.
I think you might be overlooking the potential benefits to society that would accrue if certain women contracted fatal diseases.
32: Fortunately, the emerging field of Meta Medical Ethics is attempting to determine exactly why Medical Ethics is lame.
By the authority granted to me as a Person who Teaches a Class in Medical Ethics and Once Published an Article in a Real Live Medical Ethics Journal, I hereby declare that medical ethics does not just allow boys to be given the HPV vaccine, it demands it.
35: Aah, the most illustrious honorary-PhD of my alma mater.
Same problem. The wife is not-the-doctor's-patient. I think doctors have a real ethical problem with advising their-patient to do anything for the benefit of not-their-patient.
But you could argue that a couple only has a single, shared fertility. It's in Bobby's best interests to protect his future fertility.
The Schlafly quote in 35 perfectly captures opposition to the HPV vaccine. The slut-shamers WANT sex to be fatal. The very idea that sex might have very few consequences scares them more than anything else.
From the outside perspective it seems like the Christian slut-shamers are reasoning in a tight circle. "Don't have sex because it has bad consequences" But what if we could minimize the bad consequences? "Don't do that! Then people would have sex and sex is bad!"
However, the appearance of circular reasoning is really just a result of an uncharitable interpretation. When the Christian says "Don't have sex, it has bad consequences" what he really means is "Women are the embodiment of sin and need to be controlled or killed." All this is obvious from an internal perspective.
Exactly. What the evangelicals hate more than anything is when we meddle with God's Punishment Structure. They don't mind if teenage girls have sex; they mind if they have sex and get off scot-free.
It's in Bobby's best interests to protect his future fertility.
But HPV isn't indicated in fertility problems, is it? I mean, unless you got cervical cancer before bearing children, but that isn't usually the case.
The Schlafly quote in 35 perfectly captures opposition to the HPV vaccine.
Might as well add the relevant apostropher and trollblog links, which deal with a male person who could improve the world by departing it.
You know what isn't half bad, isSchlafly beer.
But HPV isn't indicated in fertility problems, is it? I mean, unless you got cervical cancer before bearing children, but that isn't usually the case.
I thought abnormal paps could show up pretty early?
(and be cancerous, I mean. Not just abnormal.) Anecdotally, I've known women who've had their cervices (removed? dealt with?) in their twenties, and it definitely negatively affected their fertility.
There is actually something right about the argument LB is describing. Any time you start doing medical procedures for the benefit of the Greater Good rather than the patient, you are marching down the road to the Tuskegee Syphilis Experiment.
But I really don't think the slope is that slippery in this case. When you perform experiments on people because the knowledge will serve the Greater Good, the causal connection between your action and the benefit is weak and distant. Maybe the knowledge will benefit someone down the line, maybe it won't. Also the people benefited are ill defined.
With the HPV vaccine, there is a direct causal link between the action and the benefit to people very close to the patient. This case is simply not the same. We won't slide from a policy of giving the HPV vaccine to everyone to a policy of performing experiments like they did in Tuskegee.
46: Yeah, they can. But an abnormal pap usually only calls for watchful waiting (i.e., a twice-a-year pap schedule for awhile), and they only take further steps after several abnormal paps in a row, or one that shows further development. If one of those situations obtained, then they'd do a cervical biopsy, which still usually comes up non-cancerous at that stage. The cervical biopsy itself often gets all the abnormal cells hanging around.
Tuskegee was denial of care for the greater good, not giving care for others than the patient. The benefits of most forms of public health efforts are evenly distributed.
A relative of a friend is one of the 0.5% who is immune or resistant to AIDS but can spread HIV -- he's been positive for 20 years. His doctor definitely needs to think of others' health than his. (He's also a bit sociopathics and has been expelled from his family.)
I used to know someone who read Pap smears. They're very, very, very hard to get right. Or more accurately, 95% are pretty routine, and 5% are excruciatingly different. It's an area of medicine that's still incomplete and imperfect. And a false positive can cause serious problems too, so they just can't report the maybes as positive. So it was a hard, hard job.
And then came the cost-cutters and speedup.
Instead of Pap Smears, they should make them Pap In Focuses. That would help.
48: Right -- it's not so much as I think that it's a genuine ethical problem, as it is a situation with a big red flag draped over it inviting close analysis. I'd expect it to make doctors who'd prefer to be well within the lines jumpy and nervous.
Do doctors get jumpy over the ethics in a case like this? My OB would prefer to practice worse obstetrics in favor of covering his ass, malpractice-wise. I think doctors would often do whatever was condoned by a jury.
Apparently "smeary" is unfortunately descriptive of their precision. Much better than worthless but far from good enough. The most exasperating place to be.
Yeah, hence the necessity of several unusual ones in a row before they get worried. Luckily cervical cancer is pretty slow moving.
42:
It's in Bobby's best interests to protect his future fertility.
If you grant that Bobby has an interest in his reproductive fitness, rather than just fertility, and it's true that if their mother dies, children are less likely to grow up and successfully reproduce themselves, then Bobby has an interest in his mate not dying of cervical cancer, at least not until she becomes a grandmother (and possibly not even then).
In other words, Bobby would've been vaccinated on the veldt.
47 - as I said before, rubella is vaccinated against for the Greater Good, and that doesn't seem to have provoked this sort of argument. When I was at school, girls got the Rubella jab at about 13, for the sake of our own unborn babies. Now it's in the MMR, presumably to protect all random pregnant women against rubella?
My 10 year old has already asked me whether she'll still be able to get the HPV jab if she's not in school. (She can.) She clearly isn't linking it with sex - those Christians just have dirty minds.
50, 51, 54: Wasn't there a recent advance in Pap smear technology? The words 'thin film' are jumping to mind.
59 was supposed to have a question mark at the end of it.
I actually asked PK's pediatrician about this, and he said it's a straight-up problem of availability, and that when the vaccine is available in sufficient quantities he expects it to me recommended for boys too.
Also, Jroth, her *18th* bday? Surely you meant 13th.
I'll be honest, I haven't looked terribly closely at this yet, but given that someone upthread has suggested it is protecting against a pretty small risk and it's still pretty new on the scene (i.e., it's not like Tylenol where we basically have pretty solid, long term data about its safety), it doesn't seem totally irrational to hesitate.
I fairly sure that the answer is that it is only approved by the FDA for girls. I suspect that they have not done any clinical trials for boys.
I imagine that the drug company would LOVE to market this to boys, girls, dogs, sluts, and nuns.
In addition, it is a relatively painful shot. So, until it improved to be more pain-free, just girls get it.
I imagine that the drug company would LOVE to market this to boys, girls, dogs, sluts, and nuns.
And, of course, transsexual, promiscuous, cloistered canines.
And, of course, transsexual, promiscuous, cloistered canines. Those bitches?
Sorry to ruin your hypothetical, but men should get the vaccine as well, for reasons too banal to make interesting blog posts...
62: B, your legendary sense of humor has been untouched by the move, I see.
Bad Old GF had a niece who was just the most gregarious, affectionate kid in the world - her mother used to joke that she would be put on the BC patch at age 9.
I suspect that they have not done any clinical trials for boys.
i would say use condoms, what is the lesser evil something hpv vs autism, in infectious diseases vs the possibility of autism due to vaccines, i'd choose the vaccines
but here clinical decision making is very different from what i was taught, all the first choices are direct and invasive and if one can do then one should do sure by all means
i do always mistakes choosing the safest option as it seems to me and if the scores are true i know medicine only about 40%, really like nel'zya ob'yat' neob'yatnoe
But there is no possibility of autism due to vaccines.
i don't know, i use ELISA assays which use thimerosal and the kits' MSDS are all warning about its toxicity, and i'm not going to swallow it or have skin contact, so injections could be even scary
the real danger aside
Wait, I thought the whole point of HPV was that it can be transmitted by other kinds of skin-to-skin contact, not just genitals. A condom wouldn't completely protect you, right?
CDC says
For those who choose to be sexually active, condoms may lower the risk of HPV, if used all the time and the right way. Condoms may also lower the risk of developing HPV-related diseases, such as genital warts and cervical cancer. But HPV can infect areas that are not covered by a condom--so condoms may not fully protect against HPV. So the only sure way to prevent HPV is to avoid all sexual activity.
Thing #1,392 to resent the past administration for is that while once I would have accepted unquestioningly that the CDC was a honest purveyor of basically factual information, the first thing I thought on reading 77 was: "Huh. I wonder when that was written?"
genital warts are different from skin, iirc
even like circumcision could prevent cervical cancer and better hygiene, but i should really read about it what they say now
i use ELISA assays which use thimerosal and the kits' MSDS are all warning about its toxicity, and i'm not going to swallow it or have skin contact, so injections
Sure, but concentrations are pretty key here. I wouldn't want to swallow a glass of chlorine, but I sure am glad it's in my drinking water.
genital warts are different from skin, iirc
But the absence of warts doesn't mean HPV isn't present.
i meant different viral serotypes
hpv types
The confluence of this thread and the recent wedding discussion in another are reminding me of the amusement value inherent in the fact that a county near me asks applicants for marriage licenses:
1. Have you ever been married?
(If yes, must show certified copies of death certificate or divorce papers)
2. Do you have any communicable diseases?
Really, if you're lying to your intended about something that important, what's one more lie to the the county clerk?
When Molly and I applied for a marriage licence, they were giving out a pamphlet explaining why cousins shouldn't marry.
84: But you just plowed ahead anyhow, huh? Good for you guys.
||
The snark in the CT thread on the greatest philosopher of the 20th century is fantastic! I haven't burst out laughing this much in, well, months.
|>
Why thank you Parsi.
Or didn't you mean it that way?
88: I actually posted that just before I got to your entrance. Not that that changes my response.
When I was going to dinner a little while ago I saw a big autism-related banner hung up over the street. I didn't look closely at it, but it didn't seem to have anything to do with vaccines. Something about lack of coverage under some plan or other, I think.
I was quite pleased with my "giants on the shoulders of dwarves" concept.
My claim that economics sucks is getting increasing support since the economy went south. I'd just like to say that our return to barbarism during the Second Great Depression won't be my fault, but the economists'. It's not like my darkness-cursing caused the problem.
The blog is always already being killed.
(Okay, that one was a little weak.)
W-lfs-n! Does your mother know?
But you could argue that a couple only has a single, shared fertility.
oh yeah, you make this argument now, but as soon as labour starts it's every man for himself.
||
No more masturbating to Tom Geoghegan's congressional career. On the other hand, my understanding is that Quigley, the guy who won, was one of the other progressives in the race.
|>
99: If properly vaccinated.
Eh, it was always a long shot. You can't win if you don't play.
I apologize for a bit of a drive-by, I have to work sometime.
HPV vaccine as mentioned above works if given before HPV infection, exposure is through sex so give before sex. I certainly hope my daughter has sex at some point as grandkids (and social security) are a good thing. No problem giving it to boys for me, it protects against genital warts so they benefit AND as rubella vaccination shows, you got to immunize both sexes to prevent bad disease (in rubella's case, congenital rubella syndrome). The example is what UK did (immunize just girls) and what US did (immunize both sexes).
I know someone who is a strict Catholic and doesn't believe in sex before marriage, but she's over 26. I really think that insurance ought tocover the vaccine.
How is it that a hundred comments have gone by and no one has mentioned that certain strains of HPV cause penile and anal cancer in men? Gardasil is being tested on men in the US right now, and is expected to be approved in the not-too-distant future; I think it might have already been approved for men in some other, smarter country by now... and after a brief googling, yes, I see that in the UK it's approved for men.
Well, I'm not a very good reader then, am I?
Most newborns are terrible readers. The vaccine comes too late.
So, wait, 26 is the cutoff year to have gardasil covered by insurance? So I should hurry up and get on the stick before my 27th birthday?
Unfogged, home of all my healthcare advice needs.
104 meet 14 and 33
And 11 and 71.
70: well actually, not that any parent wants to imagine their child being molested or raped, but if I could get it for PK now, I would. Why put it off?
102: I married a strict catholic who didn't "believe"* in sex before marriage. I seem to remember a lot of p/v and genital/oral contact, though, even so.
*although evidence seems to show that premarital sex does, in fact, exist.
Without going into the details as it is probably lunchtime in America, locker rooms are not the nicest of places, teenage boys not always terribly sensible about matters hygienic, and so it is not at all unknown for them to contract genital warts without ever having sex. Even in the absence of cancer risk, I hear the warts themselves are no joke.
*although evidence seems to show that premarital sex does, in fact, exist.
I've got the belly to prove it!
it is probably lunchtime in America,
Truly, the Reagan revolution is over.
The Clinton era was brunch in America.
During the Bush era, we ate something which gave us worms.
The Bush era was a rowdy lunch at a seedy strip-club. We were all the talent, left sticky, dejected, covered in glitter and cologne, and just a few lousy bucks to show for it.
And we instead of tipping the dancers, we kidnapped them and took them to secret torture prisons.
given that someone upthread has suggested it is protecting against a pretty small risk and it's still pretty new on the scene (i.e., it's not like Tylenol where we basically have pretty solid, long term data about its safety), it doesn't seem totally irrational to hesitate.
I agree. I'm about 99 percent I would not deny my daughter this vaccine (certainly not because of the sex thing), but I do think it's reasonable to worry about possible long-term effects.
That said, parents who refuse to vax their kids really irritate me. Free-riders.
And parents who host exposure parties and chickenpox playdates really, really irritate me.
And parents who host exposure parties and chickenpox playdates really, really irritate me.
If these exist then I reiterate a core belief: breeders are fucking crazy.
123: Dude, you don't know the half of it. At a nanny-share we used to host, a fellow parent told us that her daughter, whom she was dropping off, might be coming down with chicken pox. The assumption was that everyone's cool with that, because, you know, exposure parties and everything.
That must surely be a lie.
125: That actually doesn't sound that bad to me. Either your kid is vaccinated, or not. If they are, who cares if they're near someone with chickenpox? If they're not, they're going to get it sometime, and better earlier than later. No one's got a serious plan for their kids to never get chickenpox despite not being vaccinated, right?
Just like a liberal, supporting chicken-pox on demand.
127: that's unbelievably great.
127: Warning -- the link in 127 is NSFT (not safe for teofilio)
I'm a little defensive about this, because Sally got something we thought at the time was chickenpox when we were on vacation when she was just about one, and a flight attendant nearly threw us off the plane for bringing an infectious baby on a plane. And I felt irresponsible at the time -- anyone not immune was going to be good and exposed to her -- but we needed to get home, and I couldn't really see the harm, given that the vast majority of people are immune, and those that aren't are going to get it sometime anyway.
132: she may have had a point:
VZV is a benign disease in a healthy child in developed countries. However, varicella can be lethal to individuals who are infected later in life or who have low immunity. The number of people in this high-risk group has increased, due to the HIV epidemic and the increase in immunosuppressive therapies.
If they're not, they're going to get it sometime, and better earlier than later.
Some people choose an appropriate time for their children to have chickenpox, others have it thrust upon them. In the end, though, it wasn't chickenpox.
He, not she. And yes, there are immune-suppressed people out there, but does that create an obligation to self-quarantine? Maybe; I'm unsure enough to still feel a little guilty about it.
"It" being chickenpox, not an appropriate time. Mea culpa.
He, not she.
Whaaaaat?!?
(er, oops)
Ooh, that "he not she" was in reference to the flight attendant. I was thinking that you were saying Sally was a she. Clearly I shouldn't be trying to read so early in the morning.
I mean, that Sally was a he. Fuck.
I've never had chickenpox. I finally was vaccinated a few years ago when I got medical coverage. I so would not have been cool with being exposed to it against my will.
I've never had chickenpox.
People who die without getting chickenpox don't get into Heaven.
Why are chicken pox parties crazy? Isn't the idea that the younger you get it, the milder it is? I thought that back in the day, everyone got it as babies and it was generally so mild that no one noticed, and that only when our disease prevention got skilled enough that it was delayed to childhood did it become an unpleasant virus.
141: Well, if I can blame it on the chickenpox, my sainted grandmother won't ever have to find out about the premarital sex.
Is that the same bird that they trained to steal cones over and over so they could take lots of pictures of people's funny reactions?
there are immune-suppressed people out there, but does that create an obligation to self-quarantine
Hard call at the margins; after all, a cold can be dangerous for immune-suppressed people as well, but we can't expect people never to travel with a cold. Chicken pox, though, is far more infectious, and can be dangerous, if rarely, even to people with normal immune systems.
In an ideal world, I think that not traveling is really the right choice, but I don't judge you, LB. There's potentially a huge cost for rescheduling (these days, it would be $400-$600 for the airline rescheduling fees alone, never mind the new fares, added hotel stay, etc.), plus work obligations, and all sorts of other inconveniences. I'm not sure what I would have done in your shoes.
All this does make me think that, in addition to not crushing the knees of the person sitting behind me, my airplane behavior should probably include the liberal use of alcohol sanitizer if I'm sick.
my airplane behavior should probably include the liberal use of alcohol sanitizer if I'm sick
140: Serious question -- when does the obligation not to go out in public if you're contagious attach? Colds, flu, chickenpox, TB, Ebola? I'm unsure enough that I still feel bad about that flight, but I'm also not sure we were wrong.
142, see 133. My understanding is not that it goes from unnoticeable to unpleasant as you age; rather, it goes from unpleasant to potentially lethal. That might make a chicken pox party sound like an even better idea, but you'd damn well better warn the other kids' parents in case they aren't immune.
148: Technically I thought 133 was arguing that LB should have kept Sally off the plane because of immuno-suppressed people, and that I was contributing something magically new and interesting with my comment. At least I hoped.
123: Dude, you don't know the half of it. At a nanny-share we used to host, a fellow parent told us that her daughter, whom she was dropping off, might be coming down with chicken pox. The assumption was that everyone's cool with that, because, you know, exposure parties and everything.
That is seriously fucked up, especially now that there's a vaccine. Back in olde times, it really was pretty certain you would get it as a kid. Even maybe from your sister just before spring vacation, forcing you to spend a week in Florida in bed while she was on the beach. (I was 9 or 10; you can omit the girlz gone wild jokes.)
Shingles, BTW, is apparently hideously painful and is also potentially dangerous for people over 60. Never getting chicken pox = never getting shingles.
My mental rule is that going out in public is ok, but if going somewhere private it's polite to check first. Trouble is with CP is that you're contagious before you even have spots, so anyone could *potentially* be an infection risk, so not worth getting too stressed about it.
I'm not so sure about younger = milder either. Anecdata, but when my 4 had it, the younger two had it worse than the older two. And I know two children who were hospitalised with CP - one was about 15 months, and the other must have been about 4 years old.
Why are chicken pox parties crazy?
It's not that they're crazy, exactly. But I think it makes a lot more sense to just give your child the vaccine.
I didn't get it until I was 13 and that was probably the sickest I've ever been in my entire life. My medical records actually contain the phrase "god-awful case of chicken pox".
Shingles, BTW, is apparently hideously painful and is also potentially dangerous for people over 60. Never getting chicken pox = never getting shingles.
Yes, yes it is. Also, never getting chicken pox or the vaccine = never getting shingles. But there's a shingles vaccine now, too, according to all the signs and ads I saw when I had the damned shingles.
Why chickenpox parties are stupid:
However, after the varicella vaccine was licensed in 1995, children could obtain immunity against varicella without the risks of natural infection and its potential complications. While chickenpox is generally milder in children, severe disease with serious complications does occur. Indeed, most serious disease occurs in previously well children.National Network for Immunization Information
Also, chickenpox does get worse as you get older and has a higher risk of complications; bad for developing fetuses, too (which is guess is technically younger).
Why are chicken pox parties crazy?
Oh, you know, people get all hammered on the pox and uninhibited and the next thing you know they're throwing couches off the roof.
never getting chicken pox or the vaccine = never getting shingles
Good point. Did you get the vaccine as an adult? If you did, how long after that did you get shingles?
158: I got chicken pox the old fashioned way in 3rd grade, shingles at 35. I learned that Rory, who got the chicken pox vaccine as a toddler, could still possibly catch the chicken pox if she touched the shingles rash and will have her own clear shot at shingles when she grows up.
Also, never getting chicken pox or the vaccine = never getting shingles.
Getting chickenpox as a child = never getting chicken pox as an adult. Chickenpox is much, much, much worse if you get it as an adult.
Also, the vaccine is much less likely to lead to shingles than an actual chickenpox infection is. It is a much weaker strain of the virus. The reason people are unsure about how long the vaccine lasts is because it is presumed that the vaccine strain of virus (live but attenuated) is unlikely to stay latent in the body, unlike the strains that actually infect people. We don't really know the statistical likelihood, of course, since it's not the year 2050 yet.
If the virus doesn't stay latent in the body, shingles can't occur. The risk is then that if your immunity wanes gradually, you could get infected by chickenpox decades after being vaccinated, particularly if you are interacting with fewer other infected people who will boost your immunity by re-exposing you to the virus.
In fact, there is a vaccine for shingles, which I think is very similar to the chickenpox vaccine, used to boost the immunity of people who have had chickenpox in the past and are therefore at risk for shingles if their immunity wanes.
In summary, the risk of being vaccinated for chickenpox is that you get the totally awful adult form of chickenpox instead of childhood chickenpox, not that you get shingles.
More information here. As a well-known goat molester I am distressed by confusion on this topic.
It's so nice to know the little artisanal touches we put into redactions around here are remembered and appreciated.
As a well-known goat molester
Goatpox is no laughing matter.
Question -- does getting shingles reawaken/strengthen your chickenpox immunity? I got a (non-painful) case of shingles before freshman year of college. Later that year I gave blood, and got a spooky letter from the Red Cross or someone saying "Give us more blood, please - you have so many antibodies for chickenpox we want to make some kind of treatment out of it." Was that related to the shingles?
Yes, shingles involves the immune system detecting infected cells and releasing antibodies to prevent more infection and inflammatory things to kill the virus, and also damage the cells that are infected. In chickenpox it's basically skin cells being attacked, whereas in shingles it's also nerve cells. But it leads to a great increase in the amount of memory B cells and antibody-secreting plasma cells, which only decreases gradually over months after the infection is resolved.
"Give us more blood, please - you have so many antibodies for chickenpox we want to make some kind of treatment out of it."
Sounds like something out of a comic book. Spider-Man's blood is unpalatable to some vampires and can reverse some kinds of cellular degeneration; LB's blood cures chickenpox.
160: I think you misread me -- I didn't suggest that people should not get vaccinated because of the risk of shingles. But, as your link recognizes, there is a risk of shingles whether your chicken-pox immunity comes from getting CP or from getting the vaccine.
I also not that the shingles vaccine is only available for people over 60, which is just totally unfair.
165: It was surprisingly creepy. "You gave blood, and now we know we like it. Give us more. Now."
Funny, the Red Cross wants more of my blood because it's squeaky clean, without some extremely common virus that most people have, plus it's O neg.
My veins are too pathetic - managed it a few times but it was getting harder and the blood people told me not to bother coming back.
168: CMV? They told me that about 50% of adult donors are CMV-negative, but the blood is desirable because it can be safely transfused to infants. They also complimented me on my platelets. Ladies....
We were uncertain for a very long time whether I had ever had the chickenpox. Apparently I had a very, very mild case when I was three having contracted it from the other little disease vectors at my nursery school, but I had only a handful of spots, wasn't particularly itchy, and the doctor told my mother that it might be chickenpox, but there were so few symptoms it was hard to tell, and that we should see what happens. My sisters all had it, but they all had it independently. It wasn't until a couple of years ago when I was getting bloodwork done for something else that the doctor threw in a varicella antibody test that we were sure that I'd had chickenpox.
This is a long and pointless story. Still, the "make them all share a popsicle so they all catch it" method is not fool-proof.
Same here, actually -- I wasn't sure I'd ever had chickenpox until I showed up with shingles.
170: CMV sounds familiar, though I'm not sure. They did tell me it was for babies and cancer patients. But they made it sound so much rarer than 50%! Now I don't feel special.
Then again, even if 50% of adults are CMV-negative, the percentage who are otherwise eligible blood donors could still be small. Specialness potentially restored!
Chicken pox parties: not crazy. If you can ensure your kid gets it while you're still staying home (not as a baby, say, but as a toddler or whatever) it's a he'll of a lot more convenient than if they get it the week before an important work deadline or the family vacation. And the vaccine isn't lifelong: you need to jeep it up. Also it's less effective as 100% protection than having had the disease.
That said, pk is vaccinated bc his nanny's kids got it while I was teaching and I didn't want to take time off.
I knew someone who had a bad case of it in college and had to go in the infirmary. I never had it, though we think that my sister had a very mild case, so I got vaccinated at age 28. I would have done it sooner, but that's when I had teh timetogo for the shots and some health coverage, though I still had to pay a lot.
Damn, I hate the stupid space bar for not working. The shot was subsidized, but I wasn't just paying a copay.
177: BG, you didn't have health coverage in college?
I got chickenpox when I was 14-15. I've had better weeks.
Law School. We had insurance which was pretty good when you needed to be referred out, but you had to get all of your primary care at the student clinic. Lab tests were covered by insurance at 100% if they were too complicated for the on campus lab to do them,but otherwise you got a discount. For a long time, there was no prescription drug coverage, but you got to pay 50% off regular prices. Later they added coverage.
The vaccine was still pretty new when I was in college.
Physicals were pretty expensive, so I refused to get one, because the first doctor I saw there was appalling, and teh privacy situation was terrible. Regular physicals were like $100 (not including labwork), but a woman's physical and pap smear were only $50.
On the other hand, I got much better psychiatric care and therapy with an off site social worker than was available at Harvard which had a more comprehensive University Health Services (for staff as well as students).
181: Huh, interesting. The no prescription drug coverage in particular. I think I'm about ten years older than you, so I'd have been in grad school at that time, and the (required) coverage there was better than what you describe.
If you can ensure your kid gets it while you're still staying home (not as a baby, say, but as a toddler or whatever) it's a he'll of a lot more convenient than if they get it the week before an important work deadline or the family vacation. And the vaccine isn't lifelong: you need to jeep it up. Also it's less effective as 100% protection than having had the disease.
Fair points. I guess there's something about the intentionality of deliberately encouraging the contraction of a disease that does give me pause. I mean, can you imagine if your child was one of the unfortunate few to develop serious complications: how would you feel? a lot worse than if he or she had picked it up accidentally, I'd guess.
But mostly I'm just pro-vax, and I think it's better to have your child vaccinated than to have him/her suffer through an illness. However, the fact that the vaccination is less effective than the actual illness in terms of long-term immunity does complicate matters, I'll admit.
I'm going to start saying "you need to jeep it up!" all the time. Who cares if it doesn't mean anything?
If you like it then you shoulda parked a Jeep on it.
186: jeep ja jeep jeep jeep park a jeep on it!
Seriously, I initially assumed that "jeep" was some sort of medically-based slang term that I was too out of the loop to know about. Shows what [how little...] I know! I jeepishly admit.
My son got chicken pox at about age 21-23 on a crosscountry airline trip. It was sever and prolonged. They recirculate air on those planes which maes them excellent disseminators of virus. I thought of writing the CD to ask if there was a chickenpox outbreak related to his plane, but I'm too lazy.
Shingles and hives seem like such nice, homey, rustic things, with honeybees etc., that I find it hard to take them seriously.
i don't know - chicken pox seems like such a rite of passage. if kids never knew what it was like to be pretty sick (as long as no serious complications), how will they have compassion for other people who suffer, or be able to appreciate the joy of being healthy again?
plus won't it mess kids and their immune systems up if said immune systems *never* have to deal with anything beyond the common cold? i think here of all the allergy problems that children raised in supersterile antibacterial soap et al environments have, and the gastrointestinal problems they apparently also get from not playing in the dirt enough and getting the occasional worm.
[for clarity purposes, i had chicken pox in the second grade, a moderate case, was home for a week or two and that was sort of fun despite the terrible itch - somehow being sick can give you a more inward, thoughtful turn as a kid]
Getting immunized is still something that your immune system does, though -- it may not be exactly the same as getting the chicken pox, but it's not at all like keeping the kid in a bubble.
Right now I'm imagining a cozy little beehive with a shingled roof.
I enjoyed my chicken pox. 3 days off school, and scratching is like sneezing and yawning as a kind of mini-orgasm.
190
if kids never knew what it was like to be pretty sick (as long as no serious complications), how will they have compassion for other people who suffer, or be able to appreciate the joy of being healthy again?
Braces? Sports injuries? Any of a thousand constantly-mutating strains of diseases that are in constant circulation in addition to chicken pox?
The other point about the bad side of overly sterile environments is a valid concern in some ways but as LB points out, doesn't have much to do vaccinations. As for chicken pox as a character-building experience though... really?
plus won't it mess kids and their immune systems up if said immune systems *never* have to deal with anything beyond the common cold
Small danger of that. Both of my daughters have had illnesses that would have been fatal a century ago, and they've had plenty of exposure to dirt, pets and all that immune-system strengthening stuff. Vaccine for chickenpox is fine by me.
God made dirt, and dirt don't hurt, as they say.
I didn't get the 'pox until I was 13 or so. I guess now I know why I was such a heartless dick for the first 12 years of my life.
if kids never knew what it was like to be pretty sick (as long as no serious complications), how will they have compassion for other people who suffer, or be able to appreciate the joy of being healthy again?,
It's really not that hard to recognize when someone else is suffering, even if you've never experienced the same sort of suffering yourself. And I'm pretty sure that the general level of compassion in human populations wasn't notably higher in earlier centuries when people had more opportunity to get sick and drop dead all over the place.
Indeed; wouldn't we expect that with enough suffering, we'd simply become inured to the sufferings of others, and overall be a less compassionate society? I.e., "You think you got it bad? No, I got it bad!" or "Yeah, so what? Everyone's getting the black plague these days."
Chicken pox parties pre-date the vaccine, and the idea was to expose all of your children at once so they wouldn't come down with it sequentially.
And I would be saying "Enjoy your days off! I have fond memoiries of my chickenpox. Scratchy-scratchy!"