Page 83 - Spring2020

students in a single classroom. In response to grandchildren were, therefore, less likely to Universal
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the significant rise in illness among vaccinated develop shingles because they had an opportu-
children, the CDC’s Advisory Committee on nity to reinforce their immunity. Without this chickenpox
Immunization Practices (ACIP) recommended periodic asymptomatic boosting, the dormant vaccination
in 2006 that all children get a second dose of varicella-zoster virus can reemerge as shingles, may be
chickenpox vaccine prior to school entry. especially in the elderly and in those with a
Previously vaccinated individuals often weakened immune system. exacting an
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report their illness as a milder infection, with Shingles is a painful disease that causes the even higher
fewer lesions and a rash that presents as papules eruption of a blistery rash, usually on one side price in the
(raised itchy bumps) instead of vesicles (fluid- of the face or body. Before the rash appears,
filled blisters). However, during the documented the affected person may have nerve symptoms form of an
outbreaks in the early to mid-2000s, up to 30 of pain, itching, burning or tingling. The rash iatrogenic

percent of cases were not mild. In those cases, itself may be uncomfortable, but it is the inter- epidemic of
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vaccinated students experienced chickenpox nal irritation from the affected nerve root that
symptoms similar to children who developed causes many individuals to experience the more shingles.
natural chickenpox. intense pain associated with shingles. Although
Recently vaccinated individuals can spread shingles is not contagious, people with shingles
the varicella virus to others through a process can spread chickenpox to those who have neither
called viral shedding—a long-known vaccine had varicella disease nor the vaccine.
complication reported in the medical litera- The shingles rash usually clears up after
ture. This can happen when an uninfected per- two to four weeks, yet some individuals experi-
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son comes in close contact with a recently vac- ence pain that can last for months or even years.
cinated person’s body fluids. Although public This condition, called post-herpetic neuralgia
health officials claim shedding is “rare,” package (PHN), generally affects one in ten people who
inserts for chickenpox vaccines openly state that get shingles. Other complications can occur
“transmission of varicella vaccine virus may when shingles infects the eye, which can dam-
occur” and warn that vaccinated individuals age the cornea and cause problems with vision,
should avoid close contact with infants, pregnant including blindness. Rarely, shingles can also
women and immunocompromised individuals lead to pneumonia, hearing problems, brain
for up to six weeks. inflammation or death. Shingles results in ap-
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proximately ninety-six deaths per year, similar
SHINGLES: A PAINFUL TRADEOFF to the number of deaths caused by chickenpox
Chickenpox vaccines are expensive, costing before the introduction of the varicella vaccine. 26
between one hundred twenty dollars and two The CDC currently estimates that one in
hundred twenty dollars per dose. However, uni- three people will develop shingles during their
versal chickenpox vaccination may be exacting lifetime, but before routine use of chickenpox
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an even higher price in the form of an iatrogenic vaccines, the agency’s estimate was that just 15
epidemic of shingles (herpes zoster). There is percent of adults (approximately one in seven)
strong evidence that the incidence of shingles would experience shingles at some point. The
1
is increasing precisely because the chickenpox CDC maintains that the condition usually oc-
vaccine is preventing people from receiving the curs in adults over the age of fifty—and that the
natural boosting effects of regularly circulating risks of getting the disease and having serious
wild-type chickenpox. complications increase with age—but a grow-
Studies show that before routine use of the ing number of studies show more diagnosis of
chickenpox vaccine, individuals who recovered shingles in children since the CDC added the
from chickenpox as children later experienced chickenpox vaccine to the childhood vaccine
recurrent asymptomatic boosting of immunity schedule. Prior to the advent of chickenpox
by coming in contact with others infected with vaccination, clinicians did not expect children
chickenpox. Parents and grandparents who to get shingles unless they were seriously im-
interacted with their infected children and munocompromised.

SPRING 2020 Wise Traditions 83