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Call to add chicken pox to MMR vaccine

Government advisers have called for chicken pox vaccination to be added to the MMR vaccine for two year olds after publication of new evidence of complications from infection.

Most severe complications occurred in otherwise healthy children and would therefore only be preventable through a universal childhood immunisation programme, the researchers reported online in Archives of Disease in Childhood.

In the accompanying editorial, the authors suggest that the ‘simple, obvious and easy' thing to do would be to switch from MMR to MMRV vac-cine, which is already available and being used in the US.

The study team used re-ports by paediatricians in the UK and Ireland of all severe cases of chicken pox complications. There were 112 cases, all requiring hospital treatment, of which the most common complications were septic shock and pneumonia. Six deaths were recorded.

The Joint Committee on Vaccination and Immunisation is already considering adding a varicella vaccine to the childhood programme, with a sub-group meeting due to be held in early December.

Study author Dr Paul Health, senior lecturer in child health at St George's University of London and member of the upcoming JVCI varicella sub group said: ‘It's clear that if we are to prevent chicken pox and the complications of chicken pox, which perhaps have been under estimated in the UK, the only way is to use the varicella vaccine.'

He added: ‘The 112 cases in the study are children with severe complications, there are many hundreds of children admitted to hospital with chicken pox which would also have to be evaluated if you were thinking about cost effectiveness.'

Apart from concerns about cost, and the usual controversy that accompanies MMR vaccination there are also some theoretical reservations about the effects that a varicella vaccination programme would have on immunity to shingles infections.

Professor Judy Breuer, professor of virology at Queen Mary University of London, who has previously been consulted on chicken pox vaccination by the government, said: ‘Because we know outbreaks of chickenpox boost the immunity of people who were infected in the past, there is a theoretical worry that reducing chickenpox will have an adverse effect on boosting.'

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