Chicken Pox Conundrum

By Christine Gorman

Since chicken pox is just an itchy nuisance for most kids rather than a real danger, American health officials have been in no great hurry to come up with a vaccine. A shot was developed in Japan and has been tested in the U.S. for a decade, amid criticism that the effort was not worth the expense. Now, at long last, the Centers for Disease Control and Prevention (CDC) is preparing to decide whether all kids should be protected against the pox.

The vaccine would have clear virtues. Despite its less-than-fearsome reputation, chicken pox causes up to 100 deaths a year, can in rare instances produce birth defects, and is responsible for untold millions of dollars in wages lost by parents staying home to tend to their sick children.

But vaccination may have risks of its own. The problem lies with the nature of the chicken-pox virus. After you get it, you always have it in your body. Normally you only suffer from chicken pox once, but the virus can flare up again later in life, producing shingles, a painful skin rash. The vaccine is a weakened form of the virus, and it too may be harbored in the body forever. The debilitated virus could conceivably spring to life years after the vaccination, and no one knows what damage might occur. Another danger is that the vaccine may not confer lifelong immunity and will therefore make a person vulnerable to chicken pox during adulthood, when the disease can be more serious. "It's impossible in the experimental studies preceding licensing to study a vaccine's effects for 50 years," says Dr. Caroline Hall of the American Academy of Pediatrics. "To the best of our knowledge, the varicella vaccine is safe."

Then there is the economic issue. In a 1985 study, the CDC determined that the medical costs of treating chicken pox were not great enough to warrant spending the money on a national immunization program. However, when the indirect costs of missed work and school time are factored in, advocates say, the U.S. could save five times as much as it would spend on the vaccine.

On the whole, the U.S. medical community seems to favor approving the vaccine. Even in healthy children, chicken pox can weaken the body so that it is susceptible to more hazardous bacterial infections. By warding off chicken pox, the vaccine could prevent secondary complications. In addition, 10 years' worth of data in the U.S. suggest that the vaccine could reduce the incidence of shingles. If the CDC decides that these advantages outweigh the possible risks, getting itchy scabs all over the body may no longer be a rite of childhood.

With reporting by Alice Park/New York