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Growing up in the US, most kids I knew (myself included) were exposed to Chicken Pox through Chicken-Pox parties where kids were allowed to play with a child who already had the Chicken Pox. Now that they have a vaccine for it, many parents opt for their kids to get the vaccine rather than exposing them through a party. What are the pros and cons of going one route versus the other?

I realize that vaccines are a controversial topic, so to be more specific, my question is based on the idea that I have a choice to get the vaccine, because based on where we live and our school options I do have a choice. I realize different countries, states, schools, organizations, etc. will have different restrictions on what vaccines are mandatory, so I'm more interested in the pros and cons for my child and for me as a parent.

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I was vaccinated as a kid but got it later on, through school, never did go to a chicken-pox party and only heard about them later. It was an inconvenience but not much more, although it was a very itchy week...I'd say see what happens and don't knowingly expose your kids to something they might get by chance on their own. Some diseases can be avoided and I take that view in my own life. –  MichaelF May 18 '11 at 13:11
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I would have preferred to have had my son vaccinated rather than him catching it via daycare for his 2nd birthday. He needed antihistamines and steroids to control the outbreak, and he had over 100 pustules on his head alone. He was NOT a happy 2 year old. –  Darwy May 21 '11 at 16:53
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Be aware that in some countries such parties are illegal (as they are seen as intentionally harming and exposing to danger a child) and you could get into serious trouble with child protection agencies. –  user548 Aug 8 '11 at 1:23
    
This isn't a real answer, rather, an anecdote. My mom did the "Chicken Pox Party" thing - vaccines weren't commonly used - if available at the time. I got it, still have some scars - but came out of the whole thing as many kids do - just fine. However, since there are actually three known strains in the US, I had only been exposed to one. Since I've moved around, when pregnant the doctors tested me and found me NOT to have the right antibodies for the most common strain in my region. As a teacher, I wound up missing a month of school to avoid getting the disease again as a pregnant adult. –  balanced mama Nov 28 '12 at 17:44
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Wish I had been able to be vaccinated instead. –  balanced mama Nov 28 '12 at 17:44

10 Answers 10

up vote 19 down vote accepted

Some people believe that obtaining the virus naturally provides better levels of immunization than you would get from the vaccine, as evidenced by the requirement for a second "booster" shot if you opt for the vaccine, or the possibility of still catching the disease even after receiving the vaccine (it is worth noting that infection after immunization is nearly always mild). Although I have not been able to find conclusive evidence, there are researchers who believe that natural exposure provides higher levels of antibodies. There is also concern that the vaccine may not provide life-long immunity, which, if true, would result in more adults catching active chicken pox infections, opening them to generally more serious and dangerous symptoms.

In past years, a fairly common reason cited for chicken-pox parties is because people are concerned with the possible link between autism and immunization vaccines. This concern was due to a study which has since been thoroughly discredited, and retracted.

However, the possible benefit of deliberate exposure is speculative, whereas the risks are concrete.

Deliberate exposure carries the risk of serious, or even life-threatening, complications. These complications are much more likely in high-risk patients (pregnant women, immune-compromised, infants), but can effect even health children rarely. Possible complications include encephalitis, pneumonia, and bacterial infection (including flesh-eating bacteria).

These are admittedly rare scenarios. However, there is one additional advantage of the vaccine over "natural" immunization: immunization from exposure to the active virus makes the individual susceptible to shingles. The vaccine may not, although I found conflicting information on this.

Edit: I updated the part above to indicate conflicting data on whether you can get shingles after receiving the vaccine. This site is a good reference for the risks of each option, but it mentions that the vaccine can still expose the person to shingles (although cases may be less frequent).

Edit2: I found this article that includes a fair amount of research and citations in favor of deliberate exposure over vaccines. However, most of what I saw in there was still what I would call speculative: the vaccine may not be as effective as claimed due to corresponding removal of reporting requirements; "there are too many questions about the adverse effects and efficacy"; "allegedly, [the wild version of the virus] produces much higher levels of antibodies than the vaccine"; questions about the the possible short-term nature of the immunity.

The strongest argument I saw in that article was that, if the reports suggesting that the immunity provided by the vaccine is measured in decades or less, it might result in more cases of adult chicken pox, and symptoms are generally much more severe in adults than in children. However, the evidence supporting that argument is peppered with terms like "unknown," "theorized," and "might."

Edit3: reworded to incorporate stronger supporting arguments against the vaccine earlier on.

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Irony: My wife and I opted to give our son the vaccine at his first year checkup. Two weeks later and he now has a mild case of chicken pox :( –  Beofett Oct 3 '11 at 14:14
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I wanted to look at your Mothering.com article, because it's been my experience that most of the 'research' they advocate is either from blog articles or from poor science. –  Darwy Jan 21 '12 at 9:35
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@Darwy I tried to diplomatically add caveats of the quality of the information there, but it really was the strongest source I could find advocating against vaccinations, as they at least made reference to studies instead of focusing on "Big Pharma" conspiracy theories. –  Beofett Jan 21 '12 at 14:23

First of all, you state:

I realize that vaccines are a controversial topic,

That is not exactly correct in a legitimate sense. The only "controversy" is manufactured. Most, if not all, the things said about vaccines by the anti-vax pro-disease folks are lies. Competent and ethical practitioners of medicine all support vaccines. To specifically address your question though:

PROS of VACCINES:

  • The vaccine is administered in a doctor's office. Understand that NOTHING is 100% safe (even breathing), so should there be any reactions, you will be with a doctor.
  • The patient that gets the vaccine will most likely not suffer from the disease, and the numerous possible side effects (scarring, pneumonia, liver damage, brain damage, death).
  • A vaccinated individual contributes to Herd Immunity, thereby offering protection to individuals who are immune-compromised, or may be unable to get the vaccine.
  • The rate of "complications" with a vaccine are about 1 in 1,000,000 (and keep in mind, the majority of these "complications" are non-permanent treatable reactions such as anaphalaxis). The complications from the disease itself are about 1 in 10,000 for chicken pox.
  • The economic impact is lessened by a vaccine (a good counter argument to the "Big Pharma" lie... In general, a vaccine nets any company much, much LESS than treating someone with the same disease).

CONS of VACCINES:

  • None beyond those listed above that have any scientific merit (i.e. the 1 in a million chance of a negative reaction). Or the non-issue of the vaccine not totally providing immunity.

PROS of POX-PARTY:

  • A very high likelihood that immunity will be gained through exposure (although it should be noted that the level of immunity is the same as for a vaccine...)

CONS of POX-PARTY:

Some good educational sites for you:

The Children's Hospital of Philadelphia.

Stanford (and I) think it's a good idea to eliminate deaths from this preventable disease.

Not sure if this link will work in this format, but here is an interesting video about opting out of vaccines in general: http://www.newsy.com/embed-video/9802/

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This is my dad's answer. I have received all my vaccines (including HPV), and I am much better off because of it. Due to my asthma and stuff, modern medicine has prevented my death a couple of times already! –  Skava Jan 1 '12 at 19:26
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First of all, vaccines are a conversial topic. There are lots of proponents and lots of opponents, and many of them fiercely defend their respective position, irrespective of the science or validity of their claims. That's pretty much the definition of controversy, no? –  Torben Gundtofte-Bruun Jan 1 '12 at 19:37
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@TorbenGundtofte-Bruun I suppose you are correct in the definition, but a controversy manufactured out of lies really shouldn't be dignified with the status of a legitimate controversy. That was my point in that first statement. Made an edit that should clarify that position. –  Larian LeQuella Jan 1 '12 at 19:49
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"An interesting source of aluminum is breast milk. After between 51 and 346 days of breast feeding, a child will have taken onboard the same amount of Aluminium as from the total US vaccine schedule for a 6 year old child. Understandably, the method of introduction is different, but it's still the same chemicals, and still introduced into the body where it can be absorbed." –  Skylar Saveland Aug 14 '12 at 22:23

My original answer (below) was correctly pointed out by beofett not to answer the OP's question. I made a different logical consstruction, which I stand by, and was critical of the lack of decision making in leaving the child not vaccinated, but I missed the actual question. So, I will answer it directly.

Question: vaccinate or deliberately expose?

Answer: VACCINATE

For generations we have intentionally exposed our children to chickenpox because it is generally harmless to children and much worse (and dangerous) to adults. So we effectively immunized the kids by giving it to them, sparing them a potentially nasty case of it as an adult.

Now that there is a vaccine, we can do the same thing without either the child or the parents actually having to suffer through a bout of the disease. This is great, because chicken pox just plain sucks. The vaccine was not available until after my daughter caught it at preschool.

So the question is .. are the risks and downsides of getting the disease worse than the risks and downsides of the vaccine. The medical profession uniformly think so, although the cynics contend that they are in the hip pocket of big pharma. I say, if you don't trust your doctor, find another one.

So I repeat my answer .. vaccinate. The risks are negligible (see the wikipedia excerpt below), and both you and the child are spared a terrible couple of weeks.

From the wikipedia article on the vaccine...

The vaccine is exceedingly safe: approximately 5% of children who receive the vaccine develop a fever or rash, but as of 1 May 2006, there have been no deaths yet attributable to the vaccine despite more than 40 million doses being administered.[11] Cases of vaccine-related chickenpox have been reported in patients with a weakened immune system,[11][12] but no deaths.


ORIGINAL ANSWER
If your child is below the vaccination age (~ 1 year I think), the decision is easy. Don't expose now, but vaccinate at the appropriate age.

So let's answer the question assuming your child is older than 18 months or so.

If you are asking the question, then you have already made the vaccine decision because your child is not vaccinated. I disagree with that decision, but that ship has sailed.

Given that, the decision to expose or not expose is binary. The vaccine issue shouldn't enter into it. Are you prepared for your child to get chicken pox now, and would you prefer a sure case now to a likely case at some unknown time in the future. Paraphrasing Harry Callahan, do you feel lucky?

Me, I expose if I can make the arrangements, primarily because when Murphy hits me, he hits me hard.

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So, chicken pox parties, eh?

Pro: You get to stay home from work for a week to care for a sick child. Oh, and you and your kid get to go to a party. And no scary needles are involved.

Con: Your child will feel like shit and itch like crazy for a week.

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"Your child will feel like shit and itch like crazy for a week." ... and possibly die. –  Duncan Bayne Aug 17 '11 at 7:31

There was a report recently that chicken pox vaccine sharply reduced deaths from chicken pox in US. We think that chicken pox is not dangerous but before the vaccine there were around 100 deaths and 11,000 hospitalizations per year. This seems to be pretty convincing.

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I'm an adult who has never had Chicken Pox. I'm also vaccination-resistant, as I found out when I had my daughter, and discovered that not only was I now susceptible to chicken pox, but also to measles, mumps, rubella, and polio. While pregnant, I couldn't get any boosters, so I was dependent on crowd immunity.

If your child got chicken pox, and you weren't the parent that stayed home, you could get me sick just by bringing it in the office, or sitting next to me on the train. Not just a little sick, either: hospital sick. It could potentially kill me. It would have definitely harmed my unborn daughter.

Your child would also, as someone stated above, be at risk for shingles, which could put them in the hospital, or kill them.

It's much, much, MUCH better for me if your child never, ever gets Chicken Pox, and it's better for them. Get them vaccinated.

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I think you're trying to offer a argument for immunization because you want people to be vaccinated so that your risk is reduced -- right? But that doesn't come across very clearly, so it looks as if you're not answering the question at all, just mentioning an anecdote. Please rephrase your answer to clearly address the question. –  Torben Gundtofte-Bruun Jan 20 '12 at 6:59

I'd absolutely opt for exposing my child to chicken pox directly rather than getting him the vaccine if we knew anyone who had it.

Chicken pox doesn't cause any of the other infections warned against in Boeffet's answer. (Hint: bacterial infections are caused by bacteria, not viruses.)

I'm all for immunizing my child against things that can kill or cripple him (polio, for instance) but for something like chicken pox, which is merely an inconvenience, I'd rather go with the method that's been working for centuries.

Meanwhile, the chicken pox vaccine has not been around long enough for anyone to be certain of its long-term effectiveness, especially when one comes into contact with a strain of chicken pox different from that which one was vaccinated for. It might be just as effective, but we don't know that it is.

There are pros and cons to either solution. However, Big Pharma insisting I need a new product to protect against something that generations of my family have healed from on their own (perhaps with the aid of some Tylenol and lotion) isn't enough for me.

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No, it doesn't cause the other things, but you are more likely to get them. Also, the virus can go dormant and cause shingles later in life. en.wikipedia.org/wiki/Herpes_zoster –  Lennart Regebro May 18 '11 at 8:28
    
@Lennart I challenge you to show any real evidence that chicken pox suppresses the immune system or does anything else to make one more susceptible to unrelated diseases. Additionally, shingles happens to only a fraction of 1% of those who have had chicken pox, and it hits them most often in their senior years: the chicken pox vaccine is so new that we don't have a vaccinated population old enough to assess whether vaccinated persons are any more or less prone to developing shingles than those who were infected as children. –  HedgeMage May 18 '11 at 9:15
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At no point did I claim that chicken pox causes complications. However, I did cite a number of medical sources that did indicate that complications can be associated with chicken pox. Feel free to provide sources that show that the risk of complications associated with chicken pox are just as likely for people receiving the vaccine. As for "bacterial infections are caused by bacteria," please note that active chicken pox results in open sores, and open sores increase the likelihood of bacterial infection. –  Beofett May 18 '11 at 11:39
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Any supporting evidence for "shingles happens to only a fraction of 1% of those who have had chicken pox?" The number I found was much higher (up to 20%): kidshealth.org/parent/infections/skin/chicken_pox.html afmc.org/HTML/consumer/health_info/shingles07.aspx –  Beofett May 18 '11 at 11:41
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Anyone who has had chicken pox is at risk of developing shingles. More than 90% of Americans over age 15 have had chicken pox. Although young people can get shingles, this disease usually occurs in people over age 50. The frequency of shingles is basically constant between the ages of 20 and 50 years (2.5 cases per 1,000 people per year). The chances of getting shingles then doubles in people between ages 50 and 60 years, and then doubles again in people age 80 to 90 years. shingles.com/info/about/what/… –  Hairy May 18 '11 at 11:50

I remember reading when the vaccine for chicken pox first came out, that there were worries that it might lead to Shingles later in life. Real chicken pox is proven to be a cause of Shingles later in life. So until someone proves the vaccine can definitely cause Shingles, I'd go with it and the maybe rather than the real disease and the proven possibility.

I've known two of my uncles to get Shingles in their 40's and it was not pleasant for them at all.

You also need to consider the option of neither pox nor vaccine option. If you don't get the vaccine and don't go to a party, your what are the chances that the kid will go through life with no disease and have zero risk of Shingles in later life versus the risk of getting chicken pox in later life, which is much more serious than chicken pox as a child. Perhaps someone might comment on that scenario.

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PRO: NO SHINGLES

According to the CDC,

Almost 1 out of every 3 people in the United States will develop shingles, also known as zoster or herpes zoster. There are an estimated 1 million cases each year in this country. Anyone who has recovered from chickenpox may develop shingles; even children can get shingles. However the risk of disease increases as a person gets older. About half of all cases occur among men and women 60 years old or older.

I've known four adults who have developed shingles, the consequences of which ranged from 2+ weeks lost from work, permanent scarring on the face where the first breakout occurred, complications from secondary bacterial infection, intense pain lasting a month or more, and hospitalization. Whether or not you consider chicken pox to be a mild disease, shingles is nearly always serious. If your child is properly vaccinated, not only do you protect against chicken pox early in life, they will also avoid shingles in adulthood. (Furthermore, the adult shingles vaccine is recommended for adults over 60 and available to those over 50 as well - See FL Dept of Health)

Also, I'm flabbergasted that parents would willfully expose their children to chicken pox when a vaccine is available. Driving to the doctor's office is an "inconvenience." If you asked a child who has been bedridden for a week, would they say their illness is merely "inconvenient"? I had a rather nasty bout of chicken pox in childhood - I had pox on my genitals and in my throat. I remember that pretty well, and inconvenient is not how I'd describe it.

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I will answer the question directly in a mo, but first an anecdote.

My oldest sons (20,18 as of this writing) had the 'pops'. When the 18 was 3, he got it before the mother of the 20 and I got married. So we got them together and they both dealt with it. That was 1995. By 2005 it was a STATE REQUIRED (Missouri) immunization for my then 4yo to get into early Kindergarten.

While the reasoning is noble (reducing the likelihood of adult issues in any case) I question the actual need. Big Pharma notwithstanding, how big of a problem was it? I'll bet that there is much more treatable disease that can be fixed with a better diet by children and that the same $M spent on say school breakfast and lunch would have a larger effect on a broader list of issues.

The direct answer to your question: Get the immunization. Even tho, in your locality, it may still be a legal option, it's no longer a realistic option. Thanks to 10 yrs of aggressive vaccination, chicken pox is no longer as prevalent in the wild. From a practical standpoint, I think it's extremely unlikely that you will now be able to catch it naturally and will simply wind up as a statistic touting the benefits of taking the vacc.

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