The consequences of refusal

I've written previously about "chicken pox parties". These types of events are coming back into vogue (they were common in the days before the vaccine, when the only way to provide immunity was to be infected), as parents mistakenly believe that "natural exposures" to these pathogens are somehow superior--and safer--than vaccinations. Though the latest rage are "H1N1 parties", chicken pox parties are still around, and potentially being held at your local McDonald's by families connecting on the internet:

I am trying to put together a chicken pox party and am looking for someone to donate their chickenpox to the event.
I was thinking of having it at McDonald or some place with toys to play on.
if you know anyone who would like to contribute or would like more information on a time and place let me know.

This is, again, one of my biggest problems with those who refuse vaccines. They frame the issue as solely "my child, my choice." Which is fine, until you put that child in with the rest of society via school, or daycare, or even trips to McDonald's. These interactions include infants who are too young to get vaccinated; people with chronic conditions or who are receiving chemotherapy, and are therefore more susceptible to disease; or those in whom the vaccine just didn't "take" (my own measles titers were not high enough to be protective, I learned last year when I was preparing to go to Mongolia--despite having 2 doses of the vaccine), and on and on. Yes, you have the right to make decisions for your child--but parents should realize that this particular choice can put a lot of others in danger.

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Thanks for making these points! I will forward your article to my %&^%* relatives as appropriate.

It's one thing to hold these at home, but to spread the virus around on toys used by non-participant kids strikes me as a possible violation of our shiny new laws against biological agent terrorism.

By D. C. Sessions (not verified) on 22 Oct 2009 #permalink

Holy wow, that's crazy. It's wacky enough that some people think "natural" exposure to herpes zoster is preferable to vaccination, and that they are willing to subject their kids to discomfort and risk. But it's outright sociopathic to expose bystanders by having your viral-exposure "party" in public.

Turning a restaurant into a disease vector source is the kiss of death for their business license and health permits plus exposes them to a law suit. The chain's head office should make it publicly clear they want nothing to do with these kinds of customers.

if you KNEW for SURE your kid would have a severe reaction to a vaccination, would you vaccinate? of course you would! it's for the greater good!

While I certainly agree that having a chicken pox party at McDonalds is rather unethical, I must take issue with the statement "as parents mistakenly believe that "natural exposures" to these pathogens are somehow superior--and safer--than vaccinations." In some cases it may very well be natural exposures are superior and safer than vaccinations. First of all, not all vaccines are 100% effective, therefore immunity can not be completely assured...unlike the case with natural infection. Second, risks of vaccines differ: it will be interesting to see how many of the worldwide vaccines against H1N1 will differ: Europe is being offered adjuvant forms of the vaccine..and there is very very little data on use of one of the adjuvants, AS03, in pregnant women. Certainly there is an increased risk in pregnant women, with about 4X the severity in normal adults, but at least we have DATA on the disease in this population...and we have little to no DATA on adjuvant in this population.

I find myself wishing that these people could be held criminally and civilly liable for the consequences of their irresponsible behavior.

Pox Parties have serious consequences. By exposing your kids to chicken pox you'll be giving them shingles later in life. Why would anybody want to give their children shingles? There is a safe and effective vaccine against varicella that renders this ridiculousness completely unnecessary.

HELP! I tutor kids at my house, and I have begged and pleaded REPEATEDLY w/ parents to keep kids who are not 100% healthy at home. In desperation, I have tried the sympathy card - I have asthma, other students have asthma, other students have family members w/ suppressed immune systems, etc. not to mention that it's a waste of their time & money, b/c the session isn't productive when a child isn't 100%. I have repeatedly emphasized that parents can call me at the very last minute to cancel and then reschedule the session at a later time -- at NO ADDITIONAL CHARGE.

However, today yet another mother assures me that child is over the flu and not contagious -- even though child is coughing. I was able to stop the coughing by giving the child hot apple cider, putting a vaporizer in the room w/ us, and having the child suck on hard candy. I have a small number of students, and their mothers are wonderful, kind people. Yet, the majority of them have looked at me in complete disbelief when I tell them that I cannot work w/ a child who is coughing / sneezing. Am I wrong in my belief that a cough or sneeze is spewing virus / bacteria / whatever into the air? Revere, it seems like your first paragraph says as much.

This may seem off-topic, but if I am having this much trouble getting parents to cancel and reschedule a 90 minute tutoring session where there is no financial penalty; how in the world do we get adults to stay home from work? I get the same reaction when I tell a parent that a coughing child can't stay that I believe that I would get if I told them that their child is a leprechaun -- complete disbelief followed by, "but she feels fine", etc. Thank you!

Regarding Chicken Pox Parties:

My wife and I both had chickenpox as kids. For the last three years she has struggled with the consequences of optic shingles. David Letterman had the same disease. Even though treatment (famivir, predforte, percocett) was within 24 hours of onset, she has lost most of her sight in her right eye due to retina damage. Her cornea was eaten away and cratered like the moon surface by the virus and cannot be corrected except with a risky cornea transplant. The knowledge of the potential years of off and on optic nerve pain, loss of vision and the inability to drive a vehicle, etc. not counting the weekly/monthly doctor and pharmacy visits and medical expense should give these Pox Party Moms a wake up call. Even the new vaccine for shigles is not totally effective. Just a thought to mention.

::mwah:: @ 5:

if you KNEW for SURE your kid would have a severe reaction to a vaccination, would you vaccinate? of course you would! it's for the greater good!

Of course not, but that's a pretty stupid hypothetical situation in this context. The correct thing to do is to compare the potential harm with the potential benefit weighted by their respective probabilities. If you knew for certain that there'd be an adverse reaction (hell, if there were even a high probability of one), no competent doctor would recommend it.

Rebecca @ 7:

First of all, not all vaccines are 100% effective, therefore immunity can not be completely assured...unlike the case with natural infection.

Neither vaccines nor infection give you a 100% guarantee of not getting an infection in the future. Is there any evidence that the acquired immunity from being infected is superior to that from vaccines?

Have you ever looked at KEGG pathways for rickettsia and compared them to some of the dietary interventions being used in autism? Look at SAM its important particularly in immuno supressed patients. Just like pneumocyctis ----
Also rickettsia are of some historical with the spanish flu --- Have we missed a growing problem? Interesting that Sulfa based chemoprophylaxis doesn't cover for this well. If your bored look up what Nicolle and Zinser learned in retrospect about the 1918 epidemic. If you rash is misdiagnosed as allergy you may never get the right treatment. Oh what you can learn on the internet!

::mwah:: at 5.

Don`t be silly. Children who WILL suffer harm (or even have a high risk) from a vaccine are not vaccinated. That is why it is important for those who can be vaccinated to get their vaccinations. Herd immunity protects the child who cannot be vaccinated.

By Daniel J. Andrews (not verified) on 05 Nov 2009 #permalink

Anyone who thinks it's a good idea to deliberately bring an infectious disease into a public restaurant, a place of food preparation, with the intent of spreading it around, deserves to be prosecuted. Reckless endangerment, perhaps?

I think this is rather one-sided, and the issue is much more complex.

Personally, I considered taking my son to a chicken pox party, as my mother did to me and my sister when we were young (as her doctor advised) but ultimately decided against it and got my son vaccinated. He was getting at the age (8) where the incidence of serious complications begin to increase.

The long term effectiveness or lack thereof is not known for the chiken pox vaccine, and, in essense, this vaccine was an economic vaccine to mitigate the loss to the economy due to parents staying home to care for chicken pox infected kids. It was not done for the right reason.

It is not at the same level of the polio vaccine.

A down side to the chicken pox vaccine is that the opportunity to catch chicken pox is decreasing, and the risk to children who do not get vaccinated goes way up. This is a cost to those who do not wish, for whatever reason, to not get vaccinated. It may turn out that more people die per year because of the vaccine, because they get it or related disease later in life.

I agree that McDonalds isn't the wisest place to have a chicken pox party.

Is it even legal to host disease parties in a restaurant? Just think of the lawsuits against both McDonalds and the organizers if a child dies because he happened to play at McDonalds that day.


First of all, not all vaccines are 100% effective, therefore immunity can not be completely assured...unlike the case with natural infection.

Natural infection is also not 100% effective at producing immunity, and for the same reasons as the vaccine (which shouldn't be surprising, as the mechanism is basically the same). Case in point: I've actually had chickenpox twice. I am considering getting the shingles vaccine; having had chickenpox twice, I am at a significant risk of developing shingles.

By Calli Arcale (not verified) on 23 Dec 2009 #permalink

My daughter Jenny is severely disabled, as a result of the chicken pox I caught when I was 16 weeks pregnant. Unlike rubella, the chances of being disabled from maternal chicken pox aren't that high (about 1%), but for us, it was 100%. On the other hand, it can have serious consequences at all stages of pregnancy. See, for example:

By Catherine Scott (not verified) on 05 Feb 2010 #permalink

I grew up in the 60s. Every "girls" book you'd read about families in times past had a brother or sister who had died or suffered some disability due to a childhood disease.

I think we don't see that anymore. Suppose childhood vaccinations and the resulting declines in those diseases are responsible? I think so!

I have had chicken pox as a child in the 60's and survived. When my oldest son was 2 I considered not having him get the vaccine as it was not that effective in 1997. After not getting the chicken pox in preschool, no one was getting it, we had him immunized and his brother too. When boosters are given it is effective and spares them at the least pain and scarring. I have just developed shingles along my sciatic nerve and it is extremely painful and is requiring massive doses of acyclovir to control it. I really think it is willful ignorance to say well I had it , they can too. We also had kids in Iron lungs from polio, blind from measels, and damaged hearts and bald from scarlet fever... Just because we don't see these diseases and their consequenses doesn't mean they do not exist. The disease may be eliminated in the US but it is alive and well when you take your unvaccinated child to Mexico, India, Asia etc. I can not teach in my school in Berkeley until I am sure that contagion is over, so many of our children are not vaccinated.