Chickenpox Vaccine Recommendations

Young boy (3-5) in bed with thermometer in mouth
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Many pediatricians and parents have been very happy with Varivax, the chickenpox vaccine.

History of the Chickenpox Vaccine

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. Even when it wasn't serious, it 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 pre-vaccine era of the United States, there was an average of 4 million chickenpox cases a year, with 10,500 of these resulting in hospitalization. Now that Varivax is routinely used, there has been a 97% decline in the incidence of chickenpox and its complications.

Effectiveness of the Vaccine

Varicella vaccination is a highly effective way to prevent disease, but it isn't perfect. Vaccination works best if an individual gets both recommended doses early in life (from 12 months old through 12 years old).

A single dose of Varivax is 82% effective at preventing chickenpox. Two doses of Varivax are 92% effective. Most individuals who do get a breakthrough infection (an infection after having been vaccinated) develop a very mild case of chickenpox (fewer than 50 lesions).

A single dose of Varivax is 98% effective in preventing severe chickenpox (cases with more than 500 lesions). Two doses will prevent 100% of severe cases. Getting a second dose is important to fully protect a child against severe chickenpox.

The Latest Recommendations

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

Children should routinely get their second dose of the chickenpox vaccine when they are 4 to 6 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 Chickenpox 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 chickenpox 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 chickenpox 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 chickenpox 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.

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  2. Marin M, Guris D, Chaves SS, Schmid S, Seward JF. Prevention of varicella: recommendations of the Advisory Committee on Immunization Practices (ACIP). Morb Mortal Wkly Rep. 2007;56:1-40.

  3. Wutzler P, Bonanni P, Burgess M, Gershon A, Safadi MA, Casabona G. Varicella vaccination - the global experience. Expert Rev Vaccines. 2017;16(8):833-43. doi:10.1080/14760584.2017.1343669

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