Chickenpox Vaccine Virus Reverting Back to Virulence

Background: There are two live virus vaccines for chickenpox licensed in the U.S. -  Varivax and ProQuad (MMRV). Both are manufactured by Merck. [1]

These are live viruses that are attenuated. Attenuated refers to a virus that is altered in some way to make it less virulent or less harmful. This can be done by passing the virus through tissue culture, embryonated eggs or live animals.[2]

The purpose is to have the virus mutate in way that it is significantly different then the original, hence when introduced to the host it will not grow well (replicating very slowly) and, in theory, lack the ability to get a person sick.

The initial mutations (or possible deletions) that are a result from the attenuated process are desirable. But there is risk or reversion  reverting back to becoming virulent/harmful.


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It is understood that administering the chicken pox vaccine carries a *small* risk of actually exhibiting the clinical chicken pox disease.[3] In the past, this was believed to be the result of a deficient immune response (the child was was not capable of “fighting” off the attenuated virus). Now, with updated research, scientists are beginning to see that children may be getting sick because the virus strain in the vaccine is reverting back to a virulent virus and specific vaccine lots are to blame.  


it was feasible that the occurrence of rash would have proved to be determined by the host genotype and immune status irrespective of the viral genotype. In that case, the virus recovered from the rash would have been a random selection of the genotypes in the vaccine. We observed the converse: four residues were strongly and consistently selected in vivo during viral spread and the formation of skin rashes.[4]

The rashes were caused by at least seven different vaccine batches.[4]

The observed differences in sequence data from V-Oka-Biken and the two GlaxoSmithKline vaccine lots were unexpected.[5]


Chicken pox is unique in this case – it has scientists asking themselves why should the varicella vaccine virus experience reversion while other attenuated vaccines (such as poliovirus) stay attenuated? They believe it is because of the unique epidemiology of skin rashes.

The explanation appears to be in the central importance of skin rashes in the epidemiology of the virus: infectious virions are shed from the rash vesicles.[4]


After immunization, vOka virus replicates locally, then infects peripheral blood mononuclear cells and may be carried to distant sites including the skin, lungs, brain, and visceral organs.[4]


What exactly does this mean? Scientists really don’t know…at least I have not read an explanation.

According to a publication from the Proceedings of the National Academy of Sciences of the United States of America (PNAS) regarding the implimentation of a national vaccine program against chickenpox:

40 million patients have consequently created a highly replicated evolutionary experiment[4]

Most countries (such as the United Kingdom) where vaccination in not undertaken, are waiting it out to determine what happens here in the States; where mass vaccination is routine.[6]

China, for example, vaccinates 1 out of 5 children – imparting the benefits of the wild-type varicella to aid in the ‘herd immunity’. In the United States, where universal varicella vaccination has been practiced, the majority of children no longer receive exogenous (outside) boosting, thus, their cell-mediated immunity to VZV (varicella zoster virus) wanes--necessitating booster chickenpox vaccinations.[7]

The United Kingdom has expressed concern over starting a vaccination program against chicken pox that has the potential to disadvantage the middle-aged and elderly. Especially since the morbidity of shingles in later life is greater that that associated with chickenpox in childhood.[7]

There are six known wild-type strains of chicken pox; in most cases, acquiring one will result in an immunity to all strains of the virus. Could the introduction of a nationwide vaccine program against chickenpox increase this number? Could it make a potentially more virulent strain(s)? Could these strains have unique pathogenic qualities? 

These data illustrate, to our knowledge, the first detailed genomic analysis of a V-Oka variant (V-Oka-zoster) isolated from a zoster patient following vaccination with GlaxoSmithKline V-Oka vaccine.Conceivably, genomic mutations or reversions to wild type, particularly those that confer amino acid substitutions, could affect virulence and restore wild-type pathogenicity. [7]

Further more, VZV (varicella) strains with unique pathogenic qualities could emerge.[7]


Ironic.

The attempt to eliminate, in most cases, a mild childhood disease has repercussions that no scientist thought was possible - the emergence of an even more dangerous strain caused by the very vaccine trying to alleviate it.
Persons that are exposed to the wild-type virus after the vaccine can still contract chicken pox resulting in harboring both the attenuated vaccine oka strain as well as the wild-type (natural) strain which are both subject to reactivation as shingles.


Shingles


The dilemma of increasing cases of shingles was already evident from the beginning – though the implementation of our national immunization program was still executed.


In an analysis published in IJT, the effectiveness of the chicken pox vaccine is heavily dependent on natural boosting– as chickenpox declines, so does the effectiveness of the vaccine. Seems the solution to this, in the United States, is more boosters, of course.

The old school of thought is that the incidence of shingles increases with age due to older individual’s immune response declining. Now, it is understood that the increase of shingles with age is due to the fact that older people receive fewer natural boosts to their immunity (as their contact with children decline).

For chicken pox, the greater good theory (the possibility of injuring a few to help many via vaccination) doesn’t even hold true in this case, for the amount of lives saved vaccinating against varicella, that many lives would be lost to shingles.


any deaths prevented by vaccination will be offset by deaths from increasing shingles disease.[5]


What is the answer to a possible shingles epidemic? An adult vaccination program against shingles.


Using a shingles vaccine to control shingles epidemics in adults would likely fail because adult vaccination programs have rarely proved successful[5]


Conclusion


40 million patients have consequently created a highly replicated evolutionary experiment[4]


An acknowledged mutating (vaccine-made) virus, reverting to a new virulent strain of varicella...

A nationally implemented vaccine program to eliminate chicken pox to only be replaced by an increase death rate of shingles...

Can you imagine if the amount of time, effort and money put in place to eliminate this mild childhood illness was diverted into efforts to ease malnutrition and hunger in our country (or heaven forbid worldwide), how many lives would be enhanced?

Something to ponder…


I would like to include some comments from the article posted in 2005 on the News Medical forum, referencing Goldman’s publication in the International Journal of Toxicology, Universal Varicella Vaccination: Efficacy Trends and Effect on Herpes Zoster: [9]



Carrier Sinclair PharmD

As a pharmacist I have been seeing an increasing number of patients with the shingles. What concerns me the most is the young ages that I have been seeing with the shingles. At first I thought that maybe it was a mis-diagnosis but as I saw more and more children being treated for the shingles I started thinking that it might have something to do with the chicken-pox vaccines. I was glad to find this article because it has answered some of my questions.

Thanks,
Carrie Sinclair


Marcella

My now 3 year old received the chicken pox vaccination at 12 months and was just diagnosed yesterday with shingles.  It is absolutely absurd for a 3 year old to have to deal with shingles.  From all the research I have been doing it seems it is widely known that children who get chicken pox under one year of age are more susceptible to shingles as children...so why are we vaccinating children with a live form of the virus at 12 months (that's a bit close to the cutoff)?  I now have to deal with keeping my 3 year old away from my 9 month old so he does not give him chicken pox.  I definately think more research should be done and the chicken pox vaccine be only recommended and not mandatory for children to start school.  Our pediatrician commented yesterday that she has seen a lot more shingles cases in young children since the vaccine started.  I believe the vaccine is totally defeating it's purpose if our children now have to deal with shingles outbreaks at such a young age.  I will definately wait longer before my now 9 month old gets the vaccine; he will not be getting it at 12 months. 


Liz

My child received her C.P. booster shot 5 weeks ago. This time she got a mild case of C.P. Two weeks later I got shingles. Why? My older children had full blown C.P. I had C.P. My immunity system was  NOT compromised. I believe the vaccines are being made with a new strain of the C.P. family, which makes no sense to me at all. This very well could explain the children's developing shingles, and their reaction when exposed to traditional chicken pox, they have half an immunity so they react with shingles. A different strain is different.

Gb

People contributing this feedback are linking chicken pox vaccine with shingles -- not from idle speculation -- but from real experience.  It is NOT to be downplayed!

My own son had the vaccine and developed shingles a few months later on his eye.  We treated it for several years, and then he developed a gbm brain tumor as an 11 year old.  There are links between the chicken pox vaccine to the shingles virus and then to brain neoplasms in the scientific literature.  People should be careful what they expose their children to for the "greater good" at least until new vaccines have had a chance to be studied for impact.

References:

[1] National Vaccine Information Center (NVIC) Website. Varicella Zoster (Chickenpox)

[2] P Provost, D Krah, P Friedman. Process For Attenuated Varicella Zoster Virus Vaccine Production – Patent 5360736. Merck & Co.,Inc. Filed June 1992

[3] Merck & Co. Inc. Varivax (Varicella Virus Vaccine Live) Package Insert

[4] M Quinlivan, A Gershon, B Mahmoud, S Steinberg, P LaRussa, N Richard, J Breuer. Natural selection for rash-forming genotypes of the varicella-zoster vaccine virus detected within immunized human hosts. Proceedings of the NationalAcademy of Sciences of the United States of America (PNAS). Vol 104 No 1 208-212. Jan 2007.

[5] The Vaccines and other Biologicals department (May 2003). "Varicella vaccine". WHO.

[6] P D Welsby. Chickenpox, chickenpox vaccination, and shingles. Postgraduate Medical Journal. Vol 82(967) 351-352. May 2006.

[7] A Sauerbrei, E Rubtcova, P Wutzler, DS Schmid, V Loparev. Genetic Profile of an Oka Varicella Vaccine Virus Variant Isolated from an Infant with Zoster. Journal of Clinical Microbiology. Vol 42(12) 5604-5608. Dec 2004.

[8] G Goldman, Medical Veritas International (MVI). Universal Varicella Vaccination: Efficacy Trends and Effect on Herpes Zoster. International Journal of Toxicology. Vol 24(4). July 2005

[9] Chicken pox vaccine associated with shingles epidemic. Sept 2005 http://www.news-medical.net/news/2005/09/01/12896.aspx 

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