Chickenpox awareness grows
By Robbie Dingeman
Advertiser Health Writer
More adults in Hawai'i are asking about the dangers of chickenpox for adults since the death last month of U.S. Rep. Patsy Mink raised awareness about how the common childhood disease can turn deadly and what can be done to prevent it.
Dr. Steve Berman, medical director of infection control at St. Francis Medical Center, said Mink's death has prompted more people to ask their doctors about the vaccine that is available. Mink died Sept. 28 at Straub Clinic & Hospital after battling viral pneumonia brought on by a case of chickenpox.
"Chickenpox in adults can be a very serious disease," Berman said.
He cited the recommendation of the Center for Disease Control and Prevention that most people who have reached adolescence without getting chickenpox should get the vaccine.
The CDC recommends the vaccine for people likely to be exposed to chickenpox such as teachers, daycare workers, international travelers and people who live or work in institutional settings.
A blood test can determine if people have been exposed to the disease and developed immunity. "If they have not had chickenpox as a child or young person, they probably ought to be immunized," Berman said.
Before a vaccine became available in 1995, public health officials estimate that 95 percent of people were immune to chickenpox by the time they reached adulthood.
While a vaccine has been available for seven years, local health officials and doctors say the main target audience has been children under age 3.
Dr. Lori Kanno of the state Department of Health said beginning this school year, the state began requiring chickenpox (varicella) vaccination for entry into preschool, kindergarten, new school and seventh grade.
Most states, including Hawai'i, no longer report chickenpox or varicella-related statistics. The six states that continue to track cases associated with the disease have reported a 67 percent reduction in disease incidence from the years just before the vaccine emerged, 1993-95, and the year 2000, the most recent data available.
The vaccine, which is manufactured by Merck & Co. Inc., has been gaining in popularity nationwide and targets children up to age 3. State Health Department statistics show Hawai'i has slightly better than the national average of 76 percent coverage for that age group who have completed their vaccinations.
Merck spokeswoman Joyce Buford said adults are 10 to 20 times more likely to have complications and die if they develop chickenpox.
Buford said the company does not typically track monthly sales by state and could not say if there has been a specific increase in demand for the vaccine in Hawai'i since Mink's illness and death. But even without the sales data, Buford said, "we believe there is heightened awareness of the need to talk to a doctor about the chickenpox vaccine."
A few weeks before she became ill, Mink visited an elementary school for a community work project where she helped paint classrooms and do yard work. After Mink's illness, school officials said they checked back but found no outbreak of chickenpox around the time of her visit.
Buford said there is concern that government health requirements leave older kids vulnerable. "They're going to be at risk," she said. And after children and teens enter school and complete their early childhood immunizations they are less likely to see a doctor regularly and catch up with any shots they missed.
Kanno, a pharmacist, said adults receive the vaccine in two shots, four weeks apart.
"The common misconception is that chickenpox is a benign disease," Kanno said. "Certain vaccines do end with childhood. This one, however, does not."
Kanno said adults may want to have blood tests to see if they are immune or just have the two shots as a precaution. "There's no harm if you were to get the vaccine, if you're not sure if you've had the disease in the past," she said.
She noted that one out of every 100,000 people will die from chickenpox while one out of 5,000 adults who contract the disease will die. "There is a vaccine to prevent this disease, so why not take it?" she said.
The CDC also recommends for adults: tetanus-diphtheria vaccine, flu (for 50 and older) and pneumococcal vaccine (65 and older), hepatitis B (adults at risk) and measles-mumps-rubella vaccine.
Kanno said there are some people who probably should not get the vaccine, such as someone who is moderately to severely ill, allergic, pregnant, immuno-suppressed because of radiation therapy or another reason. She said the risk of adverse effects are mild compared with getting the disease.
"It's something that they should be considering and talking with their doctor about," she said.
While the vaccine was once in short supply, Kanno said it's now readily available.
Reach Robbie Dingeman at rdingeman@honoluluadvertiser.com or 535-2429.
