A pediatrician's view on chickenpox and HPV vaccines

Date published: 4/8/2007

I'M ALWAYS HESITANT to mention the word "vaccine" in anything I write, because previous columns have resulted in e-mail from all over the country attacking me.

But I want to make sure that people make informed decisions. There are always risks to any medical intervention, but in my mind, the benefits of vaccines outweigh those risks.

This year, there were some changes to the immunization schedules put out by the American Academy of Pediatrics and the Centers for Disease Control that made news. The most notable involve the varicella (chickenpox) booster, the rotavirus vaccine and the hotly debated HPV vaccine.

As more children have been vaccinated, there is less exposure to "wild type" chickenpox, and therefore less natural "boosting" of immunity. This could make people more susceptible to developing chickenpox at an older age, when it can be more serious. Hence, the new recommendation for a booster dose at age 4 to 6 (the first dose is given at 12 to 15 months).

Conveniently, a vaccine became available before this recommendation that includes protection against measles, mumps, rubella and varicella. Since 4- to 6-year-olds had to get the MMR booster anyway, now we can just include the chickenpox booster in the same shot.

The new rotavirus vaccine (RotaTeq) is given orally at 2, 4 and 6 months of age. Rotavirus is the most common cause of vomiting and diarrhea in children, and is a major cause of death due to dehydration in Third World countries.

There was a vaccine for this available about 10 years ago, but it was pulled from the market due to cases of intussusception--or potentially life-threatening intestinal blockages--following the vaccine.

There were some reports recently that there might be a similar situation with RotaTeq as well. However, the CDC's recent review states that children who received the vaccine do not seem to have a higher rate of intussusception than would normally be expected in that age group.

Now for the most controversial new recommendation: Gardasil. This is the vaccine against human papillomavirus, which is the cause of warts. Certain strains are sexually transmitted and have been known for years to be the main cause of cervical cancer.

For more information about vaccines, including those that protect against HPV, chickenpox and rotavirus, check out cdc.gov and aap.org.

Date published: 4/8/2007