good?

problem, Merck has developed a new vaccine: Zostavax, licensed by the FDA in May 2006, and now being recommended for everyone over 60. Fisher finds this troublesome. “You have a situation that was created by vaccination and you have a vaccine to counteract that situation,” she notes.

It’s not only vaccine skeptics who are concerned. Dr. John E. Trainer III, a family physician in Jacksonville, Florida, who describes himself as “very pro-vaccine,” has questions about the cost of Zostavax and its effectiveness. “It’s a coin toss of efficacy,” he says. “If I give it to a 60-year-old, they are 50 percent likely to benefit from it. That means you can flip a coin and see whether it works or not. The vaccine is expensive, and the cost to the patient varies widely, depending on insurance coverage. My partner and I have not embraced the shingles vaccine.” 10

In addition to the problem of an upsurge in shingles, the chicken-pox vaccine, which is a live virus, can cause several side effects that are as or more dangerous than the disease itself. Since the chicken-pox vaccine came into widespread use, reported reactions to it have included bleeding disorders, pneumonia, skin infections, severe rashes, and such nervous-system problems as Guillain-Barré Syndrome, encephalitis, and seizures. 11, 12 Two young patients of Dr. Robert W. Sears who received the vaccine have developed benign thrombocytopenia, a blood-clotting disorder. 13 Both of the children in Sears’s practice were hospitalized, and both took more than two months to recover. “This doesn’t make me stop giving that vaccine,” Sears states. “It just makes me realize that these reactions can happen.”

NOTES

1. Department of Health and Human Services, Centers for Disease Control and Prevention, Vaccine Information Statement (Interim): Varicella Vaccine, “Chickenpox Vaccine: What You Need to Know,” 42 U. S.C. ( 13 March 2008): §300aa- 26;

www.cdc.gov/vaccines/pubs/vis/downloads/vis-varicella.pdf.

2. For an extended discussion of how the CDC numbers may be misleading, see Brian Wimer, Jacquelyn L. Emm, and Deren Bader, “Chickenpox Party: Developing Natural Varicella Immunity,” Mothering 122 (January–February 2004): 30–37; www.mothering.com/articles/growing_child/child_health/ chickenpox_party.html.

3. Personal communication ( 15 January 2009).

4. Department of Health and Human Services, Centers for Disease Control and Prevention, “Vaccines and Preventable Diseases: Shingles Disease—Questions and Answers (Herpes Zoster)” ( 19 October 2006): www.cdc.gov/vaccines/vpd-vac/ shingles/ dis-faqs.htm.

5. W. K. Yih et al., “The Incidence of Varicella and Herpes Zoster in Massachusetts as Measured by the Behavioral Risk Factor Surveillance System (BRFSS) during a Period of Increasing Varicella Vaccine Coverage, 1998–2003,” BMC Public Health 5 ( 16 June 2005): 68.

6. G. S. Goldman, “Cost-Benefit Analysis of Universal Varicella Vaccination in the U.S. Taking into Account the Closely Related Herpes-Zoster Epidemiology,” Vaccine 23, no. 25 ( 9 May 2005): 3349–3355.

7. G. S. Goldman, “The Case Against Universal Varicella Vaccination,” International Journal of Toxicology 25, no. 5 (September–October 2006): 313–317.

8. M. N. Oxman et al., “A Vaccine to Prevent Herpes Zoster and Postherpetic Neuralgia in Older Adults,” New England Journal of Medicine 352, no. 22 ( 2 June 2005): 2271–2284; http://content. nejm.org/cgi/content/full/352/22/2271.

9. This and subsequent quotations: personal communication ( 13 April 2009).

10. Personal communication ( 23 January 2009). 11. See Note 1.

12. Merck & Co. Inc., “Varivax: Varicella Virus Vaccine Live” (Whitehouse Station, New Jersey: November 2008): www. merck.com/product/usa/pi_circulars/v/varivax/varivax_pi.pdf.

13. Personal communication ( 10 February 2009).

—Jennifer Margulis

Since the chicken-pox vaccine came into widespread use, reported reactions to it have included bleeding disorders, pneumonia, skin infections, severe rashes, and such nervous-system problems as Guillain-Barré Syndrome, encephalitis, and seizures.