Children entering school are the most likely to be infected, but chickenpox can cause severe disease in infants, older persons, and persons with weak immune systems. Chickenpox can cause congenital disease in infants born to infected mothers. Infected persons are contagious 1-2 days before the onset of the rash until all skin lesions become crusted over (scabbed).
After infection, chickenpox remains dormant in the sensory nerves and can reactivate later to cause shingles if the immune system is weakened. Following the introduction of universal childhood vaccination, incidence of chickenpox in all age groups has decreased.
Those Who Should Receive the Vaccine
The American Academy of Pediatrics recommends 2 doses of the chickenpox vaccine for children. The first dose is given between 12 and 15 months. The second dose is given between 4 and 6 years, but may be given sooner. Healthy people 13 years and older who have never had chickenpox or received the chickenpox vaccine, should also be immunized with two doses of the vaccine 4 to 8 weeks apart. Another vaccine that can be given for chickenpox is MMRV.
Most children do not experience any side effects from the chickenpox vaccine. For the few who do experience side effects they are usually mild and may include: soreness, swelling or redness where the shot was given and a fever or a mild rash. Some children may experience a mild rash elsewhere on the body, tiredness, fussiness or nausea. A rash on the body may indicate that the child has developed chickenpox.
Moderate to severe side effect are very rare but may include a seizure caused by a high fever and pneumonia.
Those Who Should NOT Receive the Vaccine
Although the chickenpox vaccine is very safe and effective for use in healthy children, there are certain groups of people who should not receive the vaccine. The chickenpox vaccine should not be given to:
- People who had a severe allergic reaction to previous chickenpox vaccines, gelatin or neomycin,
- Pregnant women (avoid becoming pregnant for at least 1 month after getting the vaccine),
- People with immune systems weakened by disease or by medications,
- People who recently had a transfusion or other blood products and,
- People with moderate to severe illnesses at the time of the vaccine.
- Talk with your doctor if your child or teen falls into any of the high risk groups listed above.
Special Considerations for Children With Respiratory or Immune Disorders
Children being treated with oral corticosteroids and/or immune globulin for respiratory or immune disorders require special consideration when giving the chickenpox vaccine.
Oral Corticosteroids: The chickenpox vaccine should not be given to people on high doses of oral corticosteroids (2 mg/kg/day) for more than one month. According to general guidelines, children may be immunized after steroid use at this dosage has been discontinued for three months. However, most experts agree that vaccination after one month or more of discontinuation of steroid use is safe and acceptable. If at all possible, discontinuing systemic steroids for two to three weeks after immunization is suggested. Experts agree that immunization of children on inhaled steroids are not at increased risk of disease from the chickenpox vaccine.
Immune Globulin: As with other live viral vaccines, chickenpox vaccines should not be given within at least five months after receipt of any form of immune globulin or other blood product.
Please discuss any questions you have about the chickenpox vaccine with your health care provider. The vaccine is safe and effective in preventing this common childhood disease. The Centers for Disease Control and Prevention (CDC) has helpful Vaccine Information Statements (VIS) at www.cdc.gov/vaccines.
This information has been approved by Christopher Cjaza, MD, MPH (February 2013).