2023-04-27 18:12:42
Wild pox is no fun.
Bild: Shutterstock
Since the beginning of the year, chickenpox vaccination has been recommended for infants and children up to their 40th birthday in Switzerland. The eleven most important questions and answers.
Published: 04/27/2023, 18:12
What is chickenpox?
Varicella, also known as chickenpox or smallpox, is caused by the varicella-zoster virus and is spread worldwide. Chickenpox is highly contagious and is mainly transmitted from person to person via droplets. An infected person can infect ten to twelve people. Chickenpox causes a low-grade fever and red spots that often spread all over the body, forming itchy blisters.
How dangerous is chickenpox?
“Chickenpox is often relatively harmless, but extremely annoying. But there are also severe courses and complications, »says Anita Niederer, infectiologist at the children’s hospital in Eastern Switzerland. This year in particular, an above-average number of serious chickenpox cases were treated in the children’s hospital. These are mostly bacterial super-infections, but other complications such as vascular inflammation can also occur. According to the BAG, two out of every 100,000 infected children die as a result of chickenpox.
How dangerous is chickenpox for adults?
Much more dangerous than in children. In Switzerland, around 3,000 adults over the age of 16 contract chickenpox every year, and an average of around 140 have to be hospitalized because they suffer from brain or pneumonia. For every 100,000 infected adults, 30 people die. The older someone is, the more common serious complications are. After an infection, the varicella-zoster viruses become lodged in the nerve cells of the spinal cord, where they remain for life. In a third of people who get chickenpox, these viruses cause shingles later in life when the immune system weakens.
Is the chickenpox vaccine new?
No. “It’s been around for decades. It has been part of the Swiss basic vaccination plan for many years, »says pediatrician Anita Niederer. Until now, however, the vaccination recommendation only applied to children who had not had chickenpox up to the age of eleven. Since January 2023, the Federal Vaccination Commission and the FOPH have been recommending vaccinating all children in order to eventually achieve herd immunity against varicella. This is achieved after a few years or decades and after an 80 to 90 percent immunity of the population. The vaccine has been a standard vaccination in the USA, for example, since 1996. Varicella vaccination has been recommended in 45 countries for many years.
How is chickenpox vaccinated?
Vaccination against varicella is recommended as a two-dose primary vaccination for all infants between the ages of 9 and 12 months. Vaccination is to be done with a combined MMRV vaccine that protects against four diseases: measles, mumps, rubella and varicella. In addition, a catch-up vaccination against varicella is recommended for everyone between the ages of 13 months and 39 years who has not yet had varicella and who has not yet received a total of two doses of the vaccine.
Why the BAG’s recommendation?
There is an increase in the risk of complicated varicella diseases. But that is not the reason for the new recommendation, says Christoph Berger, chief physician for infectiology at the University Children’s Hospital Zurich and president of the Federal Vaccination Commission. There were other reasons for changing the vaccination plan. First, the availability of MMRV vaccines with durable protection after two doses. This vaccination is 92% effective against varicella and 98% against severe courses. The vaccination is also recommended because there is no increase in the risk of shingles in adults after the introduction of the vaccination for children. According to Berger, it is also possible to reduce the burden of complicated chickenpox in vulnerable children and adults who cannot be vaccinated. Because they are less likely to be infected by others.
The vaccination also significantly reduces the risk of shingles. In addition, the indirect costs of chickenpox are reduced. “If a child is sick for a week, parents often have problems with the care. You can prevent that with a little effort, with a safe, well-established vaccination,” says Niederer.
Nach the Piks.
Bild: keystone
Isn’t it better to go through the chickenpox?
“On the contrary. Going through the disease has a risk of complications, the vaccination does not. Secondly, the risk of herpes zoster, shingles, is much higher without vaccination,” says Niederer. One in three people who have had chickenpox are at risk of developing shingles. The risk increases with age.
Is there more fever with the quadruple vaccine than with the single vaccine?
In the short term, the quadruple vaccination can lead to fever. However, this is rare overall and mainly occurs after the first dose, says Niederer. Any fever after the vaccination does not pose an additional risk even at the age of 9 months. “Fever is a reaction that shows that the child’s immune system is processing the vaccine, but this is not dangerous,” says the infectiologist from the children’s hospital in Eastern Switzerland.
How do I know if I’ve had chickenpox?
Anyone who grew up in our latitudes has had chickenpox with a 98 percent probability. Anyone who was infected and still vaccinated is not taking any risks. “If someone already has antibodies against the varicella-zoster virus in their body, the vaccine virus is neutralized and excreted again,” says Niederer. “The vaccination does no harm, but then it is of no use either. Alternatively, the antibodies can be measured in individual special cases,” says Berger.
Does vaccination prevent shingles?
Yes. “Vaccination is the primary prevention of shingles. The greatly weakened vaccine virus causes much, much less shingles than in people who have had varicella, »says the infectiologist Berger. The risk of shingles arises with infection with varicella. Children who are vaccinated against chickenpox today and therefore remain free of varicella therefore have a significantly reduced risk of later developing shingles. They probably won’t have to be vaccinated against shingles when they are 60 years old.
Aren’t there too many vaccinations for children?
No. Our immune system has to deal with countless foreign substances and antigens every minute. Even in the first few hours of life, our intestines are colonized with billions of bacteria, all of which are potentially dangerous. If the immune system couldn’t deal with several hundred thousand or even more antigens at the same time, we wouldn’t survive. According to Anita Niederer, whether antigens from ten or eleven vaccinations are added does not matter at all. “The problem is the perception, because that’s done with the syringe. But from the point of view of the burden on the immune system, that’s nothing,” says Niederer. Berger also says: “It is not a problem at all to be vaccinated against various diseases if, as in the cases mentioned, it is a good vaccination.”
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