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The pox, the itch now the vaccine


Twenty-four hours after the Food and Drug Administration announced its long-awaited approval of a vaccine against chickenpox, Sherry Moyer spotted two suspicious red blisters on her son Robert's neck.

By the following day, Robert, 6, was covered with red lesions -- the telltale badge of chickenpox -- and his mother resigned herself to a tedious, week-long confinement in the Moyers' rural Baltimore County home.

"You kind of wonder why you're in the wrong place at the wrong time," says Mrs. Moyer, who gladly would have opted for the new vaccine.

Called Varivax, the vaccine is expected to be available in mid-May. The FDA says it will prevent chickenpox in 70 to 90 percent of people immunized.

If the vaccine lives up to its billing, it will largely eliminate an itchy rite of passage for millions of American children and their parents. No more oatmeal baths, dabs of calamine lotion or adult admonitions not to scratch. And no more stupefying hours in front of the television set.

About 4 million people, mostly children, get the highly contagious disease every year. They erupt in irritating sores that make them miserable. Although the disease is rarely life-threatening in children (it is far more serious in adults), it can cause scarring and keeps children quarantined for a week or more.

"This is the so-called rite of spring. You can count on the daffodils blooming and the chickenpox spreading," says Lance Berkowitz, vice president of communications for Health Management Inc., which runs the Baltimore-based Arcade and Kaufmann's pharmacies.

Mr. Berkowitz and other pharmacists may be presiding over their last chickenpox peak, when anxious parents call for advice and shelves are well-stocked with Aveeno, calamine lotion, Benadryl and other anti-itch products.

For most parents, the pox can't disappear soon enough. Pediatricians are already fielding plenty of calls about the vaccine.

Julie Helsel, receptionist for the White Marsh office of Drs. Holthaus, Schwartz and Murakoshi, says the pediatric practice has received about 100 queries about the vaccine. Ms. Helsel tells parents to "call back in about eight weeks."

Unfortunately, the new vaccine did not arrive early enough for Robert. When Mrs. Moyer spotted her son's blisters, she and Robert were at a birthday party, where he was obliviously consuming cake and infecting friends.

Robert "didn't get a horrendous case," his mother says. Nevertheless, for two days, "He was itching like crazy."

At one point, Robert "dumped his head all the way into the Aveeno [bath] and held his breath because his face and the back of his ears and neck and his scalp hurt so bad," Mrs. Moyer says.

Mrs. Moyer, 30, compares the tepid ritual bath with "taking a bath in plaster of Paris."

Having had the chickenpox at age 9, Mrs. Moyer well remembers the discomfort and the old-fashioned balms that were used to make her feel better. She also remembers passing the virus along to her mother, who was also 30 at the time.

"I was up and running and she was still in bed," Mrs. Moyer says with a hint of childlike glee.

After Robert broke out in oozing chickenpox sores, Mrs. Moyer alerted parents whose children had been exposed to the virus at the birthday party.

"Finally, it was my turn to make the phone call I had been on the receiving end of so many times," she says.

A former day-care provider, Mrs. Moyer is familiar with parents' "varying philosophies" regarding chickenpox.

Some deliberately expose their children to the virus to get it over with. Others, Mrs. Moyer says, "are mortified. They just don't want to deal with it . . . as if it were the plague. It's just a virus, what's the big deal?"

And now, Mrs. Moyer knows firsthand the challenge of keeping a bright, energetic child occupied and tending to her home-based event and meeting planning business.

"When you know you can't leave the house when you get up in the morning, that's kind of depressing," she says.

At least she doesn't commute.

"I'd be stuck looking for child care," Mrs. Moyer says. "Chickenpox is not a legitimate excuse" for missing work.

As a first-grader at the Norbel School on Park Heights Avenue, Robert works at his own pace and has not fallen behind. "It's just hard for him, the lack of school-type structure," Mrs. Moyer says. "He's lost, and he misses it."

By Monday afternoon, when he wasn't quite as itchy, Robert and his mother sat staring at each other. "So far, this is going very well, Mom," he informed her.

Mrs. Moyer had to stifle a laugh. She also had to spare gerbils Chip and Dale from Robert's constant affection. (One gerbil has since died from mysterious causes, presumably not the chickenpox.)

Robert's father, also named Robert, bought a bucket of Legos, figuring it would keep his son busy.

By Tuesday, Robert's father stayed home to give his wife a break. "That helped enormously. I actually got to go out for a while," Mrs. Moyer said.

Mr. Moyer spent the day with Robert constructing an elaborate Lego space shuttle and transport truck.

By Wednesday, it was just Robert and his mom again, home alone with "Death Traps," his favorite video, about carnivorous plants.

"If I had a nickel for every time I thought, 'Ah yes, the march of the sundews is back,' " Mrs. Moyer said.

By Thursday, Robert's chickenpox had scabbed over into a constellation of tiny red dots, signaling that he was no longer contagious and that the end of the siege was in sight. That was a good thing. After a while, even comprehensive collections of nature videos, pets, toys and computer software are no substitute for human company.

"I'm getting pretty tired of being alone all the time," Robert said, hugging a felt pterosaur. Luckily, "there is a solution to that," he added. "Tomorrow, my friend Matt from school is coming."

Yesterday, Robert was fully recovered and back in school.

"The week ended up being nowhere near as exhausting as I would have imagined," Mrs. Moyer said yesterday. Nevertheless, "I'm sure that everybody was relieved that the normal routine started today, Robert included. I'm quite sure."


Varivax, the new chickenpox vaccine made by Merck and Co., will become available in mid-May and will usher in an era when a vaccine is available for every significant childhood ailment. (Vaccines are already in widespread use for diphtheria, tetanus, pertussis, measles, mumps, rubella and polio.)

Varivax is manufactured from the varicella virus, which causes chickenpox, and is expected to prevent the disease in 70 to 90 percent of the people immunized. The vaccine works by activating the immune system response that naturally occurs when a person contracts the disease.

During clinical trials, adverse reactions to the vaccine included redness, hardness and swelling at the injection site, fatigue, malaise and nausea.

The vaccine's cost to doctors is $39 per shot. Patients will pay more for the vaccination.

A single injection of the vaccine is recommended for children ages 1 year to 12. Two injections four to eight weeks apart are recommended for adolescents and those 13 and older who have not previously had chickenpox.

The vaccine may be administered simultaneously with the measles, mumps and rubella vaccines.

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