UK heath officials have started to monitor a virus which is commonly caught in childhood. NHS GP Mark Porter, writing in the Times said it was understood that the NHS was on the verge of using a Chickenpox vaccine – bringing it into line with health services in Germany, Canada, Australia and the USA.
He explained it will join illnesses such as whooping cough, scarlet fever, meningitis and rabies, as something all doctors have to report – even suspected or confirmed, to the UK Health Security Agency, although medics are awaiting final approval of the policy from the Department of Health and Social Care.
He said: “Making chickenpox a notifiable disease will help to monitor the impact of any new vaccine programme and looks like the first step in its introduction, so I doubt we will be waiting much longer. Other countries, such as Germany, Canada, Australia and the US, are ahead of the UK in this regard — by three decades in the case of the US.”
Dr Porter explained that most people get chickenpox before they’re ten and it’s mild and doesn’t represent a threat. But he added: “However, it can be a dangerous infection for very young children and some adults, particularly pregnant women, and anyone with a compromised immune system due to illness or treatments such as chemotherapy. Indeed, adults are more likely to be hospitalised with complications from chickenpox — such as pneumonia, hepatitis and encephalitis — than children. If you are not vaccinated, it’s definitely an infection it would be better to catch as a child, just not too early.”
Two children a week in the UK are hospitalised because of chickenpox and Dr Porter said a quarter of them end up in intensive care, and as many as 1 in 20 will die, with newborns most at risk. He added: “And the virus poses a threat even before a child is born. If a woman has not had chickenpox in the past and she catches it during pregnancy, it can lead to a range of developmental abnormalities affecting the eyes, limbs, brain and nervous system of her unborn baby (foetal varicella syndrome). The risk varies with how far advanced the pregnancy is but is highest between 12 and 20 weeks (a 1 in 50 risk of FVS).
“And the mother can become very ill too. Pneumonia is the main threat to women who catch chickenpox during pregnancy — affecting about 1 in 10 — and it can be life-threatening. Nearly half (40 per cent) of those admitted to hospital end up in intensive care because they need help to breathe, and the fatality rate in this group can be as high as 10 per cent or more.”
People can hit complications if it re-emerges when a person is older as shingles. Dr Porter said: “Once caught, the varicella zoster virus is never eliminated. Rather it lies dormant in the nerves of your spine waiting to stage a comeback, often decades later, when your immunity has waned with the passage of time or has been impaired by illness.
WDepending upon which part of your body is affected it can be unsightly and very debilitating. Most people recover within a month or so but, if it involves the eye, it can lead to visual loss. Whichever part of the body is affected, a significant minority of people will be left with pain for months, sometimes years. And, like chickenpox, shingles poses more of a threat in people with weakened immune systems, in whom it can lead to life-threatening infections.”
Dr Porter said eligibility for the effective vaccine which exists is ‘likely to be extended’ as the Joint Committee on Vaccination and Immunisation (JCVI), has advised lowering the age threshold for most people to 60, and removing the present cut-off of 79. He added: “So, once the changes have been adopted and phased in, everyone over 60 will be eligible, as well as younger adults with weakened immune systems.
“I can’t say how long these changes will take but I suspect it will be years rather than months. In the meantime, present eligibility criteria will remain unchanged. I know many of you regard the cut-off at 79 as ageist and discriminatory but please don’t shoot the messenger. Or your GP practice. We don’t make the rules but we do have to stick to them.”
The vaccine — what to know
• The JCVI has advised offering two doses of chickenpox vaccine to all children, at 12 and 18 months, with a catch-up programme for older ones who may have missed out on natural immunity from catching the virus during the social distancing era of the pandemic.
• Eligibility for the shingles vaccine is complicated but, as of September 2023, it includes anyone turning 65. If you reached 65 before then you will have to wait until you are 70.
• Anyone aged 70-79.
• If you are 80 or over, you should have been vaccinated already unless you are much older and missed the initial rollout. You will not be offered catch-up vaccination.
• Anyone aged 50 or over with a severely weakened immune system due to factors including some types of leukaemia or lymphoma, past organ transplant, strong immunosuppressive medication, HIV or chemo/radiotherapy. In special cases it may be offered to younger adults too.