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Q. Are chickenpox parties a good idea?

A. Chickenpox, caused by the varicella zoster virus, used to be a childhood rite of passage. In the 1990s, vaccines were given only to kids at high risk for severe varicella, like those with weakened immune systems, but it was thought to be unnecessary for generally healthy kids. The rationale to expand to all kids was primarily economic—parents missing work to care for sick kids resulted in too much lost revenue. Today, given that the vaccine prevents up to 90 percent of all cases and almost all severe ones, most states require it before starting kindergarten. While rare, some kids do get a rash and fever from the vaccine, whereas getting chickenpox naturally usually involves mild itching and low-grade fever (though it can be life-threatening for kids with compromised immune systems). My biggest concern is how long immunity from the vaccine lasts. Varicella is a much more severe disease for adults—what if the immunity doesn’t take (up to 20 percent of kids aren’t fully immune after the vaccine) or doesn’t last more than a few years? Many states have instituted a second dose of the vaccine at age 5 to address this issue, but we still don’t have long-term studies to show how long the vaccine lasts. Personally—and this is not the mainstream answer—I’d rather wait until children are 12, check their immunity with a blood test, and then immunize those who aren’t yet immune. As for the chickenpox party, I’m hesitant to recommend unnecessary exposure, but I wouldn’t worry if your child ends up being accidentally exposed at school.

Lawrence D. Rosen, M.D., is the founder of the Whole Child Center in Oradell, New Jersey, one of the first green, integrative primary care practices in the U.S.

Have a question for Dr. Rosen? 
E-mail him at drrosen@kiwimagonline.com.

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