Monday, April 27, 2009

Day 14

My youngest son overheard a conversation I had with a friend about the Varicella (Chickenpox) Vaccine. He didn't much like what he heard. We were discussing the CDC recommendation for a second dose of vaccine - and the probability that further boosters would be needed for those who had been immunized. He was immunized at age 6. Late for the current recommendations, but I had waited until his pediatrician was willing to enthusiastically recommend it. When he immunized his grandchildren, we chose to immunize our son.

A few days after that conversation, my son learned that a friend's younger brother and sister had just come down with chicken pox. We had an extended discussion about the risks of chicken pox at age 13 vs as a young (or not so young) adult. We discussed the symptoms he might experience and the one potential benefit of actually contracting the disease instead of getting the booster. He's never been a weenie about needles, so I'm pretty sure his decision was based on his awareness the longer immunity he would likely receive if he caught chicken pox. I was very careful not to pressure him one way or the other, although I did tell him that he was rapidly approaching an age where the risks of the illness would significantly outweigh the benefit of longer term immunity.

After checking with the mother of the poxed children, we stopped in for a 45 minute visit. That started the countdown. About day 3, he started having symptoms. I was able to convince him that it was far too early and that the chances of contracting chicken pox weren't nearly 100%.

I did forget to give him my statistics lecture in which I say that statistics only apply to populations and that for him this will be 100% or 0.

Today was day 14. He has been complaining of a mild headache and scratchy throat since yesterday. He had found something he thought was a tick on the top of his head. Visualizing it through his incredibly thick hair was tough, but I managed. Definitely not a tick. It was a tiny red bump that looked like he'd scratched it. He suggested that maybe it was a chicken pox lesion. I countered with the suggestion that he ought to have others on his torso if that was the case. So he took off his shirt. There they were. About a half dozen red bumps on his chest and another 10 or 12 on his back. If he's lucky, that's all we'll find, but if this is chicken pox (and they do look like chicken pox), he can keep popping out with them for the next few days.

The incubation period for Chicken Pox is 10-21 days, but the average really is 14-16, so he's right on time. Now I need to figure out who to notify among the many people he's been around for the last few days.

They were desperately short of altar servers for the First Communion services at our church on Saturday. He was the only altar server at 2 of the 3 services - took a break during the third. He was also assigned to serve at the 9 am Mass Sunday morning. He was fine then, so he did that too. AND he went to Sunday School -- without complaining at all. He even went to his karate class before we dropped him off at a friend's house so we could go to our Boy Scout Troop committee meeting. Fortunately, same friend where he was exposed to Chicken Pox.

If you hear about a major chicken pox outbreak in the Mid Atlantic states, that will be our fault.


Anonymous said...

The Urban family is slowly wiping out our homeschooled friends with the pox!!!!!

Lots of Benadryl and tylenol!!!!!!

Judy said...

Depending on who he breathed on the last few days, maybe some non-homeschooled friends as well.

Anonymous said...

Wow. Was this a responsible choice? What are the chances that he infected some adults who could get really sick?

I appreciate the longer immunity, but I am queasy thinking about people deliberately infecting themselves and then walking around in public exposing a lot of people who didn't make the same choice they made.

Given your job, I'm darn certain that you care about public health, so I'd be really curious to hear your reasoning here. Maybe I'm misunderstanding something vital about how transmission works...

A Fellow Mid-Atlantic Resident

Judy said...

If he had ANY symptoms beyond a mild headache (easily explained by the local pollen count) over the weekend, I'd have kept him home.

He was immunized. Expose 100 immunized kids to chicken pox and 85-90% of them won't get chicken pox. Or maybe they would have a really mild case like my son and continue to spread the virus, because he really doesn't look sick.

We didn't intend to expose anyone who didn't choose to be exposed and he won't be going anywhere else until I'm certain he isn't infectious. I've warned everyone I could warn about this. At least I know HE was exposed so I will keep him home.

His case is mild enough that I wouldn't have pegged it as chicken pox if I didn't have the time line from exposure. He'd have had the opportunity to infect a great many more people because he just doesn't act sick right now. He's a little itchy and he has fewer than 50 lesions at this point. He doesn't have a fever and he wasn't coughing when he was around other people in the last few days.

I understand your concern, but I didn't really see a need to quarantine an immunized, apparently healthy child.

Anonymous said...

I was trying to decide if I should immunize my almost 4 year old son against chicken pox. My feeling was that I had it, so no big deal if he gets it. I am very weary about in over vaccinating our children. Not as in vaccines are bad.

I'm so on the fence. Why vaccinate my child when now they are saying that it may take more boosters? And apparently from your story he could even still get chicken pox!

It's so hard being a parent and deciding what's best to do!!


Judy said...

As with any decision, discuss thoroughly with your child's health care provider. Each case is individual as is each child and family situation.

My son has a very mild case of chicken pox. If I didn't know he'd been exposed, I would probably continue to send him out to infect friends and neighbors. I might not know more than that his scalp itches and he has a few spots on his chest and back and a few more he doesn't care to show me.

I do believe that the vaccine has made this a much milder case than his older brothers had. I hope that the "booster" he gets in immunity from small number of lesions is enough that he won't need further injections.

The CDC and American Academy of Pediatrics currently recommend initial immunization and a follow-up booster. I don't know if they'll eventually recommend further boosters.

If it helps your decision-making process, I'm not sorry I had my son immunized against Chicken Pox. I'm also not sorry that he caught this mild case for the boost it will give his immunity.

ecrunner said...

It is always a hard decision when you know the chances of them contracting something (be it the pox or anything)are there, but they aren't showing signs or symptoms. Hopefully he feels better soon and that it doesn't get worse or spread to others. Hopefully all will be well soon. In the end, it will be a nice/funny story to tell.

Anonymous said...

For the anonymous mom on the fence about vaccinating, you rarely hear about the serious consequences of chicken pox since most children are immunized.

However, 20 years ago, it was not uncommon at all to have children develop meningitis and encephalitis with resultant permanent brain damage due to chicken pox. So, not all children just have a few lesions with a mild fever.

If you want to read the consequences of unvaccinated childhood chicken pox, you must go back many years to actually see the results.

Good luck and really listen to your pediatrician. He/she is the one who really knows the result of the disease, not your counterparts who were children when the vaccine came out or were so young they weren't aware of the consequences of the disease.

Anonymous said...

I got it at 34, a couple of years ago, I did not even know the vaccine existed otherwise I would have run to my doctor begging for it....
It was horrible, I had blisters every possible where, on my tonsils, on my private parts, inside my ears, everywhere.
I'm a woman, what if I would have been pregnant when I got chickenpox?
If you catch it in the 1st trimester it can be horrific for the unborn baby.
I still don't know where I got it, on the bus? At a party with lots and lots of people, some of them with small children? I still don't know.
I can't even start to comment on such a strange idea as exposing your child to something so uncomfortable and potentially scarring, and to the risk of getting herpes zooster when older.

Judy said...

The point was so that, IF he had inadequate immunity from the vaccine, he would develop immunity by having a milder case at age 13 than would likely happen at age 31 - or older.

The vaccine has been pushed as being very effective. After our experience, I really don't think it's nearly as effective as has been claimed. He was 6 when first immunized against chicken pox - and 13 when he caught it. That's a pretty steep decline in immunity over a relatively short period of time.

I really hope he didn't expose anyone and I didn't intentionally send him out to do so.