Measles vaccinations are currently part of the Australian childhood immunisation schedule, with two doses providing lifelong immunity. However, before the early 1990s, only one dose was given, meaning that people born between 1966 and 1994 – dates that include me – are almost certain to be under immunised.
And while chickenpox is considered to be milder than measles, it can still lead to fever, headache and fatigue, in addition to itching spots. “Around one in 100 people with chickenpox develop complications,” says Gibney. “Infection in adults is usually more severe than in children, and infection during pregnancy can be more severe for the mother, and can result in congenital abnormalities or severe disease in the baby.”
Why are some of us not immune?
Chickenpox vaccination has been available in Australia since 1999 and included in the national childhood vaccination schedule since 2005, with a single dose at age 18 months.
“I assumed I’d been vaccinated,” says Hanlon, who has since discovered that the UK, where she grew up, has never routinely vaccinated children against chickenpox (a recent recommendation to change this hasn’t yet been acted on).
So, what about that scar on her chin? Gibney says Hanlon’s situation of incorrectly assuming immunity due to having had chickenpox in childhood is not uncommon. She explains there are a few possible reasons, the first being that the scar is from something other than chickenpox.
The other is a mistake in the family history. Hanlon says her mother was initially told her older brother’s illness was not chickenpox but family folklore, which Gibney notes isn’t always reliable, went on to say otherwise. Another explanation, according to Gibney, is that Hanlon’s blood antibody levels could have “drifted down over the years”, falling below the level measurable by the test.
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It’s recommended that women planning pregnancy consider their immunity to both diseases. While neither chickenpox vaccinations can be given during pregnancy, doctors still suggest pregnant people have their immunity levels tested.
“The reason we check during pregnancy is so women can be extra careful if they know they’re at risk,” says Clements. “Or, if they contract chickenpox closer to birthing, we might be able to use some special medications during the birth.”
What to do if you discover you’re not immune
Clements, who works as a general practitioner in Townsville, says that you should see your GP if you are immunocompromised, planning pregnancy, work in health or childcare or are planning travel to south-east Asia, where measles remain endemic. If you aren’t in these categories but are now wondering about your immunity levels, there’s less urgency, but you could include discussion about vaccination in your next regular health check-up.
“As GPs, we break things down into categories,” Clements says. “Is it recommended we test everybody? No. Is it recommended we test at-risk people? Yes. That leaves a lot of people in-between who, if they’re concerned or think they’re at risk, can talk to us about testing and immunisation.”
I’ve now had two MMR (measles, mumps and rubella) vaccinations. After speaking to the experts, I’m also now planning to look into a new vaccine against shingles, reconsider my risk of whooping cough and book my annual flu shot. And, yes, I’m up-to-date with COVID boosters.
Hanlon says her discovery about not being immune to chickenpox went down the list of priorities within the busyness of parenthood, though it made her even more determined to follow the full vaccination schedule for her twin girls.
“I’m thinking it could be a good idea for me to get the vaccine,” she says. “We’re very lucky to be in a country where we have these options to look after ourselves and our families.”
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