Chicken Pox Vaccine Recommendations

Immunization Basics

A case of chicken pox will usually keep your child home from day care for at least six days.
A case of chicken pox will usually keep your child home from day care for at least six days. Photo © Jaren Wicklund

Many pediatricians and parents have been very happy with Varivax, the chickenpox vaccine.

History of Chicken Pox

Although the chickenpox vaccine was first developed in Japan in 1974, it wasn't until 1995 that it became approved in the United States and was added to the immunization schedule.

Before the chickenpox vaccine began to be routinely used, chickenpox (varicella) was a very common childhood illness, that even when it wasn't serious, still left children miserable for at least a week.

And unfortunately, sometimes these chickenpox infections did become serious, leading to hospitalization and even death.

In the United States, in the pre-vaccine era, "there were an average of 4 million cases of varicella that resulted in 10,500-15,000 hospitalizations and 100-150 deaths every year," many of which occurred in children. Now that Varivax is routinely used, there has been "a substantial decrease in incidence" of chickenpox and its complications.

History of the Chicken Pox Vaccine

Although "varicella vaccination has been found to be highly effective in preventing disease," it is not perfect.

A single dose of Varivax has been shown to be about 71% to 100% effective at preventing chickenpox, with most kids who get a breakthrough infection (an infection after having been vaccinated) getting a very mild case of chickenpox. The chickenpox vaccine does offer a greater than 95% protection against moderate and severe chickenpox infections, though, although several studies showed 100% protection against the most severe cases of chickenpox, with more than 500 lesions.

If they just get one dose of vaccine, that does mean a lot of kids will still get chickenpox, though, including some who may get moderate or severe infections.

The Latest Chicken Pox Vaccine Recommendations

Because of these breakthrough infections, the Advisory Committee on Immunization Practices (ACIP) to the Centers for Disease Control and Prevention (CDC) issued a new recommendation for a routine chickenpox booster shot back in 2006.

Children should routinely get their second dose of the chickenpox vaccine when they are four to six years old. Older children and adults should also get a second dose if they haven't already.

This second dose has been shown to provide increased protection to vaccinated children.

Children can still get a very mild breakthrough case of chickenpox, even after two doses, but they likely won't have a fever and will often have fewer than 50 chickenpox lesions.

What You Need To Know About The Chicken Pox Vaccine

The chickenpox vaccine is a live vaccine that is usually well tolerated by most children. Other things to know about the chickenpox vaccine include that:

  • the first dose of chickenpox vaccine is given when toddlers are 12 to 15 months old
  • the second dose of the chickenpox vaccine can be given any time, as long as it is at least three months after the first dose
  • the chickenpox vaccine may help prevent chicken pox if given to a susceptible person (hasn't had a natural chickenpox infection and hasn't already been vaccinated) within three to five days after they are exposed to someone with chickenpox
  • the chickenpox vaccine is not causing a surge in shingles cases or a shingles epidemic. This is simply another anti-vaccine myth that is used to scare parents away from vaccinating their kids and protecting them against vaccine-preventable diseases. The trend in rising shingles cases in adults began before we started giving kids the chicken pox vaccine in the United States and the trend in rising shingles cases in adults exists in other countries that do not routinely give kids the chicken pox vaccine.
  • the chickenpox vaccine does not now and has never contained thimerosal
  • a combination vaccine with MMR and Varicella (ProQuad) is available to decrease the number of shots that children need to receive when they get these vaccines

And remember that adults should get a chickenpox vaccine too if they didn't have chickenpox when they were younger.

CDC. Epidemiology and Prevention of Vaccine-Preventable Diseases. The Pink Book: Course Textbook - 13th Edition (2015)

Commentary: the case for universal varicella immunization. Seward JF - Pediatr Infect Dis J - 01-JAN-2006; 25(1): 45-6

Varicella infections and varicella vaccine in the 21st century. Vazquez M - Pediatr Infect Dis J - 01-SEP-2004; 23(9): 871-2

Plotkin: Vaccines, 6th ed., Copyright 2013

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