ASK DR. H: Chickenpox vaccine not perfect

Q: One of the girls in my daughter’s preschool class came down with the chickenpox even though she was vaccinated against it. Can you explain why her vaccine didn’t work? — A.B., Atlanta

A: The two-dose chickenpox vaccine is very effective, with published efficacy data of 98 percent to 99 percent efficacy after receiving the recommended two-dose vaccine given four to eight weeks apart.

That means that roughly 1 percent or 2 percent of those immunized will still get a bout of chickenpox.

The reason for the vaccination failure is that the individual failed to mount an adequate immune response to protect against someone infected with the chickenpox.

The good news is that this little girl likely had a much milder bout of chickenpox than she otherwise would have had if she had not received any vaccination.

The vaccination almost always protects against serious disease.

Q: For the past few months, I’ve had a swelling of my left testicle that’s occasionally painful. My doctor sent me for a sonogram that found a varicocele. I still have lingering concerns about the possibility that I may have testicular cancer. What would you suggest? 
— D.V., Philadelphia

A: A varicocele is essentially a varicose vein problem that can occur in a man’s scrotum. Just like the varicose veins that can develop in the legs, a varicocele develops because of a defect in tiny one-way valves that help to pump blood against gravity, away from the testicle and toward the abdomen and heart.

Your ultrasound did not show a solid mass, meaning that you do not have testicular cancer. It’s good that you’re at least thinking about testicular cancer, because when diagnosed early, it’s one of the most curable forms of cancer, exceeding 90 percent overall.

Just like varicose veins in the legs, most varicoceles do not cause much pain. Since you are experiencing pain, I’d advise seeing a urologist. One important consequence of a varicocele which may be a problem for a couple planning a family is male infertility.

Dr. Mitchell Hecht is a physician specializing in internal medicine. Send questions to him at: “Ask Dr. H,” P.O. Box 767787, Roswell, GA 30076. Because of the large volume of mail received, personal replies are not possible.

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