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Study Links Kids Vaccine to Fever Seizures

In our quest to keep you informed about the latest news on Chickenpox and its treatments here is some news to make you think when choosing a vaccine to use. 

From the AP

By MIKE STOBBE – 8 hours ago

ATLANTA (AP) — Children suffered higher rates of fever-related convulsions when they got a Merck & Co. combination vaccine instead of two separate shots, according to a new study presented Wednesday.

The results prompted a federal advisory panel on vaccines to water down their preference for the combo vaccine ProQuad, which protects against measles, mumps and rubella as well as chickenpox.

In the study of children ages 12 months through 23 months, the rate of seizures was twice as high in toddlers who got ProQuad, compared with those who got one shot for chickenpox and one for the three other diseases.

The risk translates to about one extra case of convulsion for every 2,000 doses of ProQuad given said Dr. Nicola Klein, who lead the federally funded study. She presented the data at a meeting of the Advisory Committee on Immunization Practices.

The study focused on children who develop fevers and then go into convulsions — an occurrence that frightens parents but usually has no lingering consequences. There were no deaths in the new study.

ProQuad was licensed in 2005. It’s been in extremely short supply since last year, when Merck suspended production because of manufacturing problems. The company expects to resume ProQuad production next year.

The panel had previously taken a position that they preferred doctors give children as few needlesticks as possible, and that ProQuad is preferable to giving separate shots.

It voted Wednesday to amend that, to say they’re no longer voicing a preference for ProQuad over the separate shots.

“Safety, shortages, delivery issues — lots of reasons not to state such a strong preference,” said member panel Patsy Stinchfield, an infectious disease expert at Children’s Hospitals and Clinics of Minnesota.

Merck officials said their own research, though preliminary, also showed a doubling of the risk in children within five to 12 days of vaccination. However, the occurrence was low — about 5 cases in 10,000, Merck officials said.

They said there was five times more chickenpox antigen, the key ingredient, in the ProQuad shot than in the stand-alone chickenpox shot. But they said it’s not clear that would explain the difference in seizure rates.

For some reason, the difference disappears when comparing rates for 30 days, Merck officials added.

Klein’s research checked seizure rates only at seven to 10 days after vaccination, and looked at about 43,000 kids who got ProQuad and 315,000 who got the two other shots together. It found fever-related seizures occurred at a rate of 9 per 10,000 children vaccinated with ProQuad, compared with 4 per 10,000 for those who got separate shots.

Klein is co-director of Kaiser Permanente Vaccine Study Center in Oakland, Calif., one of seven sites in the study. Her work was funded by the U.S. Centers for Disease Control and Prevention.

ProQuad costs $124 per dose, about the same as the two other shots combined.

Chickenpox and Traveling

If you are traveling you should be aware of the many types of diseases and illnesses that you may run into abroad. Chickenpox is one of them and while the United States has a vaccination program, many countries do not.

The CDC has put together some good information on travel and the risks of disease and illness. Here is an excerpt from their site on travel and Chickenpox. For the full article you can visit the link at the end of the story.

Description

Varicella (chickenpox) is the primary infection with the varicella zoster virus (VZV). It is a highly contagious rash illness transmitted by airborne or droplet pathways. The usual incubation period is 14-16 days (range 10-21 days). Second cases of varicella have been reported in immunocompetent persons but are rare. Following varicella, VZV establishes latency in sensory nerve ganglia. The virus can reactivate later in life, causing herpes zoster (shingles), usually localized to one to three dermatomes. Transmission of VZV to a susceptible person occurs through contact with either a person with varicella or, less commonly, a person with herpes zoster.

Occurrence

Before introduction of varicella vaccine in the United States in 1995, varicella was endemic, with virtually all persons being infected by adulthood. Since implementation of the varicella vaccination program, incidence has declined in all age groups, with the greatest decline among children aged 1-4 years. Data from passive and active surveillance have indicated a decline in varicella cases of 70%-84% from 1995 through 2001 (1-3). The downward trend in varicella has continued in the United States through 2005 with an approximately 90% decline in incidence from 1995 in active surveillance sites with high vaccine coverage (CDC, unpublished data).

Risk for Travelers

Varicella and herpes zoster occur worldwide, but varicella vaccine is routinely used for vaccination of children in only some countries, including the United States, Uruguay, Qatar, Australia, Canada, Germany and South Korea. The risk of varicella infection for travelers coming to the United States is lower than for travel anywhere else in the world. However, VZV is still widely circulating in the United States. Additionally, exposure to herpes zoster, while less common than varicella, poses a risk for varicella infection. In temperate climates, in the absence of vaccination, most varicella cases are reported among preschool- and school-aged children during winter and spring. Studies suggest that in tropical areas VZV infection occurs later during childhood and adolescence resulting in higher susceptibility among adults compared with temperate climates (2). Reasons for this difference in disease epidemiology are unclear. They may relate to the agent’s heat lability and/or to factors such as the tendency for less indoor crowding in tropical regions.

For more on International travel from the CDC

Lake County Florida

It was reported in the Orlando Florida area that there was yet another outbreak of Chickenpox.

Parents get notices of Lake County chickenpox cases

February 16, 2008

THE VILLAGES

Five fourth-graders at The Villages of Lady Lake Elementary School have come down with chickenpox, prompting county health administrators to send a cautionary letter to parents and order a thorough cleaning of the school.

In the letter, the Lake County Health Department urged parents to have their children vaccinated against chickenpox if they have not already done so.

Although chickenpox usually manifests itself with a fever and an itchy rash, in rare cases, it can lead to serious illness and death.

The five infected children had received at least one dose of chickenpox vaccine.

For the full story 

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