THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Monday, June 26, 1995 TAG: 9506260024
SECTION: LOCAL PAGE: B1 EDITION: FINAL
SOURCE: BY MATTHEW BOWERS, STAFF WRITER
LENGTH: Long : 154 lines
Julia Price would like her 5-year-old son to get sick. Now.
Don't get her wrong - this Chesapeake mother loves her Ryan. But he's starting school in the fall, and he's never had chickenpox. And if he doesn't catch it this summer and get it over with, he might have to miss school later.
Whenever it happens, Price probably will have to miss work to be with him, maybe a week or more. She's a night-shift maternity nurse at the Portsmouth Naval Hospital, and baby-sitting already is tough enough to arrange for Ryan and his older sister, Samantha. It would be even harder to find a sitter for a sick, contagious child.
The daughter has had chickenpox - ``10 to 14 days of hell,'' Price recalls, with oatmeal baths and socks on her hands to keep her from scratching. Price wishes her son didn't have to go through that, but she knows that eventually most kids do. And she can ill afford to miss work - or paychecks.
``Two weeks without pay is a significant amount,'' she says. ``That can really hurt you.''
All this makes Price - and many other parents - very interested in the new chickenpox vaccine arriving in area pediatricians' offices.
The vaccine, the first in the country for chickenpox, is manufactured by Merck & Co. of West Point, Pa., and sold under the trade name Varivax. The federal Food and Drug Administration approved it in March, and the American Academy of Pediatrics now recommends it.
Until recent years, chickenpox was just another bothersome rite of childhood for practically everyone - run a little fever, break out in itchy spots, stay away from your playmates. But with both parents now likely to be working outside the home, and more single parents serving as lone breadwinners, a kid with chickenpox can quite a drain on a household's income. Multiply it by two or three siblings (children often catch the highly contagious disease in succession) and it gets worse.
They can't go to school. Day-care centers and baby sitters usually won't accept them until they're no longer contagious. And most employers don't give time off with pay for sick children.
Price knows. A single mother, she says she's been fired for staying home when her children were ill.
And having to stay home is the concern of most of those ringing the phones of local pediatricians.
The callers, though, largely balk at the $50 to $60 cost of the vaccine and at not knowing how long the immunity will last.
The vaccine is roughly twice as expensive as other common vaccines because it's new and because it has to be specially stored at 5 degrees or colder. Medicaid and all but a handful of insurance companies won't pay for it because it's not yet considered a required immunization, like the standard measles-and-mumps shot that children endure before entering school.
And while studies have shown that the chickenpox-vaccine immunity lasts for as long as 10 years, many parents - and many pediatricians - worry that they won't know if or when it might wear off after that period, and when a booster shot would be necessary.
Doctors say it's preferable to get chickenpox before adolescence, because afterward the disease hits much harder and there's a much higher chance of serious complications, such as pneumonia, encephalitis or inflammation of the brain. Even with the vaccine's availability, the surest way to avoid getting the disease as an adult is to have it as a child.
In Suffolk, 50 to 60 people have called the Lakeview Medical Center about the new vaccine, but in the two weeks the center has offered it, only four or five children have actually received the shot.
``Most of the kids who are getting it are from a large family, a lot of children,'' said Angela J. Stepp, a pediatrics nurse. ``And if they catch it, the parents are out of work a lot, if they catch it consecutively.''
Dr. Ruth Vogel in Virginia Beach has vaccinated about 10 children in the past month.
``On a regular day, probably anybody who comes through here asks about it,'' says Mary S. Shaw, a nurse in Vogel's office. ``They're not so concerned with the chickenpox: `Losing a week at work - we're talking about a lot of money there.' ''
State health officials are taking a cautious approach, and not yet offering the vaccine. They're waiting for more recommendations from federal and state medical experts.
There's concern that vaccinating only some people might mean that children wouldn't have as much chance to catch it, and therefore would be more likely to catch it as adults, when its consequences could be more serious.
And the state doesn't have the money for the vaccine anyway, says Alisen A. Guyet, coordinator of the immunization program at the Virginia Beach Health Department.
Guyet has had her own three children vaccinated. But in general, she says, kids have less to gain than some adults.
``Really, the prime candidates are those adults who haven't already had it, because they become the really sick puppies.''
Any state law requiring immunization for schoolchildren probably is years away, says Richard C. Carney, public-health adviser with the state Health Department. But he plans to have his 2 1/2-year-old daughter vaccinated this summer.
``The vaccine is still so new, even getting it is still hard,'' he says. ``Everybody's excited about this. I'm sure it'll be a popular vaccine.''
Chickenpox was the last common childhood disease without a vaccine in this country. Cases usually are mild, but 9,000 Americans are hospitalized with complications each year, 80 percent of them children. About 50 previously healthy children die each year from it.
Price, the Chesapeake mother and nurse, knows the risks. But she's still not having her son vaccinated. His pediatrician and other doctors she works with say it's too new and there should be more tests. She trusts their judgment.
So she doesn't pull her son out of day care even when another child has chickenpox, trying to expose him the old-fashioned way.
``He's been in with the best of them,'' she laughs. ``But he's never, never, never . . .'' MEMO: NEW VACCINE
What is it? Varivax, a new vaccine against ``varicella,'' commonly
known as chickenpox, was licensed in March by the Food and Drug
Administration and is becoming available locally.
Who makes the vaccine? Merck & Co., West Point, Pa.
What does it cost? Around the country, inoculations range from $50 to
$80; generally pediatricians charge about $55. The cost is higher than
those for other common vaccinations, because the vaccine is new and
because it must be specially stored at 5 degrees or lower and used
within 30 minutes of being taken out of storage.
Who should get it? The American Academy of Pediatrics recommends it
for healthy children and young adults who haven't had chickenpox. Those
1 year to 13 years old should get a single dose; people over 13 should
get a second booster shot a month or so later. Ask your doctor.
Who shouldn't get it? Children with immunity deficiencies, such as
some forms of cancer or HIV, the virus that causes AIDS; children taking
steroids; pregnant women. Some pediatricians also advise against anyone
taking the vaccine. They warn that it hasn't been tested sufficiently,
and that, because it's not known how long the immunity lasts, the
vaccine could dangerously postpone the disease until adulthood, when
it's more severe and complications are more common. Again, ask your
doctor.
Does it hurt? Like a shot in the arm, which is what it is. Some
people may develop pain, redness or a slight rash.
Does it work? The vaccine has been tested on more than 11,000 people.
It worked more than 95 percent of the time, and it's still working
through a 10-year follow-up period. Testers who caught chickenpox anyway
had mild cases, with relatively light fevers and less than half the
typical 400 to 500 skin eruptions, or spots. For more information, ask
your doctor or call the American Academy of Pediatrics, (708) 228-5005.
Is it required for school? Not yet. State law requires immunization
for measles, diphtheria, pertussis (whooping cough), tetanus, polio,
rubella (German measles), mumps and typhoid. Some public health
officials expect the chickenpox vaccine to be added to the shot given
for measles and mumps.
What if I can't afford it? You're out of luck, for now. Few insurance
companies or Medicaid are paying for it yet, and local health
departments aren't providing it free because they don't have the money.
That's largely because it's new and not considered a required
immunization, like those required for admission into public schools.
Sources: Public-health and -school officials, American Academy of
Pediatrics ILLUSTRATION: Color photo
by CNB