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Stroke after varicella vaccine

Updated: Aug 23



Varicella is the medical term for the virus that causes two separate illnesses in the general population. The first is the chicken pox and the second is shingles. The chicken pox is a childhood illness for which a vaccine was developed because of the incidence of morbidity and mortality in children who were at risk and the significant amount of time that parents lost at work when children were required to be quarantined at home.


Children and people who are at risk are those who are infants, children and adults who are immunocompromised and adults.


Just as with other medications or vaccinations there are side effects and possible drug interactions. A vaccine often uses attenuated germs ñ viruses or bacteria that in their full strength would cause the illness but in a weakened condition will only cause the body build up an immunity to the virus or bacteria.


This is the theory behind most vaccinations, including the flu vaccine that offered each fall.


Chicken pox, caused by the varicella virus, is contagious and can spread from one child or adult to another. Chicken pox is a relatively mild disease in children but can be very debilitating for weeks as an adult. In more severe cases it can cause brain swelling, skin infections and pneumonia.


The varicella vaccine was introduced in 1995 and since that time records show that 90% of those who receive it haven't gotten the disease and the 10% who do get a milder form of the disease.


Although considered to be rare, there is a side effect of the varicella vaccine that is significant. Stroke after varicella vaccine has been reported in the literature on a number of occasions. The ischemia (or loss of oxygen to the brain) appears to happen in the basal ganglia and does account for 1/3 of all strokes that happen to infants.


Looking at that percentage logistically it must be realized that the number of strokes that happen to infants is very small so even at 1/3 that number remains small enough that physicians continue to consider the vaccine safe. However, for those infants who suffer from the strokes days or even weeks after the vaccine that is small consolation.


Some point to the fact that because the vaccine is still available on the market that must mean that it is safe. That couldn't be further from the truth. There is evidence that the MMR vaccine, a triple vaccination against Measles, Mumps and Rubella, is linked to the development of autism in toddlers. However, the vaccination continues to be offered to families even though the alternative of vaccinating against the same illnesses through three different vaccinations appears to be much safer.


The risk benefit ratio must be weighed when considering administering the vaccine. The highest risk group of children are those infants for chicken pox while that group also appears to be at the highest risk for development of stroke after varicella vaccine. Parents must weight the risk of developing the disease vs. the risk of stroke in their infants before pursuing the vaccination route.



RESOURCES


Journal of Pediatrics: Stroke after Varicella Vaccination

http://www.ncbi.nlm.nih.gov/pubmed/15580216


Pediatrics: Varicella Vaccination and Ischemic Stroke in Children

http://www.ncbi.nlm.nih.gov/pubmed/19171574


Stroke: Chickenpox and Stroke in Childhood

http://stroke.ahajournals.org/content/32/6/1257.long


The Journal of Pediatrics: Stroke After Varicella Vaccination

http://www.jpeds.com/article/S0022-3476%2804%2900718-8/abstract


University of Maryland Medical Center: Shingles and Chickenpox

http://umm.edu/health/medical/reports/articles/shingles-and-chickenpox-varicellazoster-virus


Center for Disease Control and Prevention: Stroke is not Associated with Varicella Vaccination in Children

https://cdc.confex.com/cdc/nic2008/webprogram/Paper15644.html

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