When the chickenpox vaccine first arrived in 1995, it received a tepid reaction from many of us in the medical field. It was seen as a nice-to-have, something useful, but far from life-saving.
The general public felt that chickenpox was something everybody got, it was usually pretty mild, you got over it, and then you were immune. No big deal. Chickenpox was so common that, as a physician, you developed a certain comfort level with it: Here’s how we alleviate symptoms, this is how long they’ll be out of school, this is when they can go back.
But my perspective was radically altered soon after the vaccine came out. I was a junior faculty member with about three years’ experience in practice. One of my partners asked for a second opinion about one of his patients. He had been in practice maybe eight to 10 years longer than I, his patient was a little girl around 24 months, and he sensed that something was amiss.
It turns out that she did have chickenpox…and was in the ICU for weeks.
He pulled me into the exam room and said, “This looks like chickenpox, but she doesn’t look good. There’s something wrong here.” I knew right away that she did have chickenpox—I’d seen plenty of cases before—but this girl was on the verge of being critically ill, with fever, respiratory difficulty, and other clinical issues.
We rushed her to a children’s hospital across the street, straight into the ER for an evaluation. It was grim: serious bacterial infections including a streptococcal empyema and a streptococcal infection in her mediastinum—all complications from chickenpox. She was in the ICU for a couple of weeks with multiple chest drains, IV fluids, antibiotics, and sedation for the discomfort and frightening surroundings (for a 2-year-old).
Thankfully the ending was a happy one, and in the succeeding years I continued to see her in the office when she came for appointments with my partner. I remember her as a teenager, a healthy young woman who had made a complete recovery. But she had very nearly died from a case of chickenpox run wild, a “mild childhood illness” we all expect to get and get over.
There’s a reason we have vaccines, and it’s to prevent infections that can cause incredible hardship.
While the chickenpox vaccine was still too new at the time for this patient to have received it earlier, it still could have spared her the trauma of an ICU stay and her parents the agony of watching and waiting at her bedside for two weeks.
For me, it was a wake-up call. I don’t think there are any vaccine-preventable illnesses that are free of potentially catastrophic complications, even “just the measles,” even “just chickenpox.” There’s a reason we have vaccines, and it’s to prevent infections that can cause incredible hardship. Straightforward illnesses can take a horrible turn, and on those rare occasions, you’ve never been as grateful for anything as you are for their vaccines.
