Varicella Vaccine
What Is Varicella?
Varicella, commonly called chickenpox, is a highly contagious infection. It is caused by the varicella zoster virus (VZV). It produces an itchy rash. It can cause serious complications, especially in adults, newborns, or people with suppressed immune systems.
VZV spreads from person to person by:
- Airborne droplets of moisture that contain the virus
- Direct contact with fluid from a varicella rash
It is most contagious just after the rash has broken out. It is also contagious 1-2 days before the rash erupts and until all of the blisters have crusted.
Symptoms include:
- Mild headache
- Moderate fever
- General feeling of malaise
- A rash consisting of small, flat, red spots that become raised to form round, itchy, fluid-filled blisters
It takes about 10-21 days after contact with an infected person to develop varicella. The illness lasts 5-10 days. The rash usually develops on the skin above the waist, including the scalp. It may also appear on the eyelids, in the mouth, upper airway, or voice box, or on the genitals.
Treatment generally focuses on reducing itchiness, such as using anti-itch cream. For rashes that become infected, antibiotics may be used. Antiviral drugs may be given to teens and adults. For newborns and people with compromised immune systems, immune globulin is given right after exposure.
What Is the Varicella Vaccine?
This is a live virus vaccine that is given by injection. The varicella vaccine can also be given in a combination vaccine called the MMRV. This protects against measles, mumps, rubella, and varicella.
Who Should Get Vaccinated and When?
The vaccine is recommended for most children aged 12-15 months. The second dose is given between ages 4-6 years.
For those who have not been vaccinated, the CDC recommends the following schedule:
- Up to age 13 years—2 doses, with an interval of 3 months between the first and second dose
- 13 years and above—2 doses, with a minimum interval of 4 weeks between the first and second dose
If you are an adult who has not been fully vaccinated and have never had chickenpox, it is recommended that you get vaccinated. Talk to your doctor, though. If you have certain condition, you will not be able to get the vaccine.
If you or your child has not been vaccinated but has been exposed to chickenpox, getting vaccinated within three days can help lessen the virus or offer protection from the infection.
What Are the Risks Associated With the Varicella Vaccine?
The varicella vaccine, like all vaccines, can cause problems, such as severe allergic reaction. The risk of serious harm or death is extremely small. Most people do not have any problems with the vaccine.
The most common complaints are:
- Soreness or swelling around the injection site
- Fever
- Mild rash
Less commonly, seizure caused by fever, pneumonia, or other serious problems (eg, low blood count) have been reported after the vaccine. There is some evidence that children are more likely to have seizures after getting the vaccine if they are given the MMRV vaccine as the first dose. The Centers for Disease Control and Prevention (CDC) recommends that parents be advised of the risk of fever and seizure and have the option to choose the combined or separate vaccine.
Who Should Not Get Vaccinated?
You should not get the vaccine if you:
- Are moderately to severely ill, wait utnil you feel better to get the shot
- Had varicella
- Had a life-threatening allergic reaction to gelatin, the antibiotic neomycin, or a previous dose of the varicella vaccine
- Are pregnant—Get the vaccine after you have given birth. Women who are trying to get pregnant should wait until 1 month after getting the shot to get pregnant.
Talk to your doctor before getting the vaccine if you have the following conditions:
- Have HIV/AIDS or another a disease that affects the immune system
- Are being treated with medicines that affect the immune system (eg, long-term steroids)
- Have cancer
- Had a recent blood transfusion
What Other Ways Can Varicella Be Prevented Besides Vaccination?
Avoiding contact with people who have the virus can reduce the chance of getting it.
What Happens in the Event of an Outbreak?
In the event of an outbreak, people who have not had the virus or the vaccine should be vaccinated.
WHERE CAN I GET MORE INFORMATION?
Immunizations/Vaccines
American Academy of Pediatrics
National Immunization Program
Centers for Disease Control and Prevention
References:
Baker CJ, Pickerling LK, Chilton L, et al. Advisory Committee on Immunization Practices. Recommended adult immunization schedule: United States, 2011. Ann Intern Med. 2011;154(3):168-173.
Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years—United States, 2011. MMWR. 2011;60(5).
Chickenpox (varicella) information. Rutgers University website. Available at: http://health.rutgers.edu/Immunizations/Varicella.htm. Accessed February 2, 2007.
Klein NP, Fireman B, Yih WK, et al. Vaccine Safety Datalink. Measles-mumps-rubella-varicella combination vaccine and the risk of febrile seizures. Pediatrics. 2010 Jul;126(1):e1-8.
Marin M, Broder KR, Temte JL, et al. Use of combination measles, mumps, rubella, and varicella vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2010 May 7;59(RR-3):1-12.
MMRV and Febrile Seizures. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccinesafety/Vaccines/MMR...tudyfeature.html. Updated July 2010. Accessed October 5, 2010.
Varicella chickenpox quick sheet. Arizona Department of Health Services website. Available at: http://azdhs.gov/phs/oids/epi/pdf/qs_varicella.doc. Accessed February 2, 2007.
Varicella (chickenpox) vaccination. US Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/vpd-vac/varicella/default.htm. Accessed February 2, 2007.
1/31/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years—United States, 2008. MMWR. 2008;57;Q1-Q4. Centers for Disease Control and Prevention, MMWR website. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5701a8.htm. Updated January 10, 2008. Accessed January 28, 2008.
10/14/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Macartney K, McIntryre P. Vaccines for post-exposure prophylaxis against varicella (chickenpox) in children and adults. Cochrane Database Syst Rev. 2008;(3):CD001833.
Last reviewed December 2010 by Lawrence Frisch, MD, MPH
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.