Last month I saw a six-year old girl when I was on call. She was recovering from chicken pox when she become unsteady on her feet and clumsy. She was suffering from cerebellitis – inflammation of the lower part of the brain that controls coordination. This happens to some previously well children as a result of chickenpox. Some of them never fully recover. Although deaths from chickenpox in childhood are rare, a practising paediatrician working in a children’s hospital like me sees many more children sufficiently ill to be in hospital as a consequence of chickenpox than cases of meningococcal sepsis and meningitis about which there has been an enormous recent expression of public concern. As a children’s doctor, it is part of my job to stand up for children – and children are being seriously harmed by chickenpox all the time – and that harm is entirely preventable.
There is an interesting parallel to be drawn here with flu.
We are currently offering flu vaccine every winter to all 2-7 year old children. This reduces their risk of getting sick from flu and prevents some of them ending up seriously ill in hospital. It also is expected to protect many old people from getting and dying of flu – flu deaths are mostly among old people but old people often get flu directly or indirectly from children.This benefit to old people is part of the cost/benefit calculation that drives the decision to offer the vaccine to all children in the UK.
But if the viruses that are in the flu vaccine were to cause a handful of children to die or have lifelong injuries and many more to be hospitalised every year (which they don’t), we certainly wouldn’t use it, even if many more elderly lives and many NHS costs were saved by doing so. So we would not make such an error of commission – harming our children to help our elderly – but when it’s an error of omission (not giving varicella vaccine) that hurts the children and (perhaps) helps elderly people, it’s ok.
That doesn’t seem right to me, or many other paediatricians who have experience of what this virus can actually do to a small but significant group of children.