State considers chicken pox rule

Tuesday, January 27, 2004 | 12:00 a.m. CST; updated 11:49 p.m. CDT, Sunday, July 20, 2008

Missouri parents might have another vaccine to add to their list before sending children to school next year.

The state Department of Health and Senior Services has proposed adding immunization against chicken pox to the list of required vaccinations, which already includes polio, measles, mumps, rubella, hepatitis B, tetanus and diphtheria.

The new rule was proposed last November, and the period of public comment ended a month later. After a period of review by the Joint Committee on Administrative Rules in the Missouri General Assembly, the rule is set to go into effect in the fall of 2005.

Chicken pox can have serious complications, including death, and is highly contagious. A secondary infection associated with chicken pox causes about 100 deaths per year nationwide. Food and Drug Administration guidelines call for chicken pox vaccinations as soon as possible after a child’s first birthday.

Vaccinating all children before they enter kindergarten could be difficult. Missouri law allows parents to opt out of having their children vaccinated, and the list of exemptions to the vaccination rule is expanding. Parents can cite religious and — if a bill in the Missouri House of Representatives passes — philosophical objections to immunization, or simply sign a document stating that their child has had the illness.

Mary Martin, public health manager for the Columbia-Boone County Department of Health, said that protecting the community from infection is difficult when not all families are participating.

“The idea of a new immunization requirement with parental exemptions gives school nurses heartburn,” she said.

Robert J. Harris, a pediatrician practicing in Columbia for 40 years, has seen severe infections resulting from chicken pox. Despite the possibility of exemptions, Harris said he is “absolutely” in favor of chicken pox vaccinations. He said that mass vaccination reduces the incidence of the disease even among those who haven’t been immunized, as long as they are in the minority.

More than 20 states have passed chicken pox-vaccination requirements for students entering school and day care since the vaccine was approved in 1995. Since then, the Centers for Disease Control and Prevention has been studying the effectiveness of the vaccine in communities across the United States. It has found that as use of the vaccine in these areas increases, chicken pox cases decrease substantially.

Through mandatory vaccination, the Department of Health and Senior Services hopes to reduce the number of cases of chicken pox reported in Missouri from 4 million to 400,000 per year. It estimates the new rule to cost the state about $59,260 annually.

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