Second Cases of Chicken Pox

Chicken Pox Basics

A child with chicken pox
A child with chicken pox. Photo courtesy of the CDC

Children typically build up a lifelong immunity to chicken pox after getting an infection and don't get it again.

Why Some People Get Chicken Pox Twice

There are some situations in which a child might get chicken pox more than once though, including:

  • getting their first case of chicken pox when they were very young, especially if they were younger than 6 months old
  • having a very mild or subclinical infection the first time

Although most children who get chicken pox are considered naturally immune and don't need to get a chicken pox vaccine, you might consider getting them vaccinated if they were very young or had a very mild case of chicken pox. That should hopefully keep most of these kids from getting chicken pox twice.

And with so many kids having been vaccinated, there are also fewer folks around to expose an immunocompromised child or adult to chicken pox.

Those factors make it even less likely for a child to get a chicken pox twice.

Most People Don't Get Chicken Pox Twice

So if it is so uncommon, why might a child still get chicken pox twice?

One common reason for a child to have a 'second' attack of chicken pox is simply because the first case, or maybe the second case, was really something else that was misdiagnosed as chicken pox. Although a full-blown case of chicken pox is hard to miss, other viral infections and even insect bites can be misdiagnosed as mild cases of chicken pox, especially by non-medical personal, including parents and daycare workers.

Although testing for chicken pox is rarely required, there are tests that can confirm if a child has chicken pox. These can be helpful in mild cases or when a child has a suspected second case of chicken pox.

Tests for chicken pox can include:

  • PCR or DFA of cellular matter from an unroofed vesicle
  • viral culture of fluid from chicken pox lesion
  • IgG and IgM antibody levels

Fortunately, with the rise in use of the chicken pox vaccine, the incidence of first and second cases of chicken pox is much less common these days.

Still, according to the CDC, "Immunity following varicella infection is considered to be long-lasting and second cases of varicella are thought to be rare. However, second cases may occur more commonly among immunocompetent persons than previously considered."


Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases (Eighth Edition)

Manual for the Surveillance of Vaccine-Preventable Diseases

Vaccines (Sixth Edition) 2013

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