Refusing varicella vaccine linked with increased disease risk

Children whose parents refuse the varicella vaccine appear more likely to develop the disease, according to results of a study.

Jason M. Glanz, PhD, of Kaiser Permanente’s Institute for Health Research in Denver, and colleagues studied 133 children enrolled in one health plan who developed varicella between 1998 and 2008. Each case was matched by age and sex to four randomly selected children who had been enrolled in the plan for the same amount of time, but who had not developed chickenpox.

Among the 133 children who developed chickenpox, seven had parents who refused the varicella vaccine vs. three refusals among the 493 controls.

“Compared with vaccine acceptors, children of vaccine-refusing parents had a nine-fold increased risk of varicella illness,” the researchers noted. “Overall, 5% of varicella cases in the study population were attributed to vaccine refusal. We believe these results will be helpful to health care providers and parents when discussing decisions about immunizing children.”

The findings suggest that if more parents refuse vaccines, the incidence of varicella and related complications also may increase over time, especially among individuals at high risk of severe infection. “These results provide evidence to counter the misperception among some parents that unvaccinated children are not at risk for vaccine-preventable diseases,” the researchers concluded.

The study was supported in part by grants from the National Institute of Allergy and Infectious Diseases and Kaiser Permanente Colorado Institute for Health Research.

Glanz JM. Arch Pediatr Adolesc Med. 2010;164:66-70.

Glanz and colleagues have provided additional data supporting the risky business of not vaccinating all children against the common childhood vaccine-preventable diseases. Unfortunately in everyday practice, many families still adhere to the gossip columns and the vaccine paranoia outcries alleging pharmaceutical and government malfeasance. They forget that we as pediatricians are everyday folks with a tremendous scientific training and knowledge about vaccines, and that we too have children and grandchildren for whom we recommend vaccines without reservation.

The real trouble with the antivaccine folks — they all know and understand the concept of herd immunity and rely on it exclusively to keep their own children protected. But they do not want to "take a chance" on vaccinating their own children. Rather, just let someone else be the recipient of the "dangerous product," which they all know works and saves lives. Sadly, their children are often caught in the deadly game they play. Even more dastardly, their own children often become the biohazards of the community, spreading entirely preventable, wicked diseases. Other parents really need to be aware of vaccination rates in their child's daycare or school, so they too can make an "informed choice" about their child's attendance and exposure there.

– Stan L. Block, MD
Infectious Diseases in Children Editorial Board