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Chickenpox was once a common childhood disease until a vaccine was invented to prevent it. Today, you can keep your children from getting chickenpox by making sure they get the vaccine.
The purpose of a vaccine is to prevent you from getting a specific disease. The chickenpox vaccine is called the varicella vaccine. It is called varicella because the varicella virus causes the disease. It is given by injection . More than 90% of people who receive the vaccine will not get chickenpox. People who get chickenpox after having the vaccine usually dont get as sick.
How Do Health Care Professionals Diagnose Chickenpox
A doctor usually bases a diagnosis of chickenpox on the clinical history and physical findings. However, laboratory exams can be useful. Your doctor can test blister fluid if there is a concern about secondary skin infection by Staphylococcus or Streptococcus bacteria. If the blisters are infected with bacteria, such a bacterial culture can help determine which antibiotic may be needed.
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Vaccine Side Effects And Risks
Redness, soreness and swelling where the needle was given are common. Fever is less common and sometimes, a mild chickenpox-like rash can occur 5 to 26 days after getting the vaccine. If this occurs, the person with the rash should stay home until the blisters are dried out with scabs, there are no more blisters and there are no new spots or bumps forming. It is important to avoid persons who may be at high risk for severe disease, including pregnant women, newborns, patients in hospital or out-patient settings, and persons who are immunocompromised . The rash should be kept covered and gets better on its own.
Salicylates should not be given to a person for at least 6 weeks after varicella vaccine vaccination due to the association between aspirin, varicella, and Reyes Syndrome, a disease of the liver and brain.
Serious allergic reactions are rare and may include trouble breathing, wheezing, hives and rash. Report any side effects or severe vaccine reactions to your health care provider.
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Does The Vaccine Always Prevent Chickenpox
The main purpose of any vaccine is not necessarily to entirely prevent the disease, but rather to prevent the serious or complicated form of the disease. Recent studies have shown VV to be as much as 95 percent effective toward preventing chickenpox and 100 percent effective for preventing severe chickenpox. Even though between one and four percent of vaccinated children can still get chickenpox, these breakthrough infections are mild and usually result in only a few days of a low-grade fever and a few spots.
Guidance On Reporting Adverse Events Following Immunization
Vaccine providers are asked to report the following AEFI in particular, through local public health officials:
- Varicella that is moderate or severe and occurs within 7 to 21 days of vaccination with varicella-containing vaccine.
- Any serious or unexpected adverse event temporally related to vaccination. An unexpected AEFI is an event that is not listed in available product information but may be due to the immunization, or a change in the frequency of a known AEFI.
Refer to Reporting Adverse Events Following Immunization in Canada and Adverse Events Following Immunization in Part 2 for additional information about AEFI reporting.
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Why Is The Chickenpox Vaccination Not Part Of The Routine Childhood Immunisation Schedule
There’s a worry that introducing chickenpox vaccination for all children could increase the risk of chickenpox and shingles in adults.
While chickenpox during childhood is unpleasant, the vast majority of children recover quickly and easily.
In adults, chickenpox is more severe and the risk of complications increases with age.
If a childhood chickenpox vaccination programme was introduced, people would not catch chickenpox as children because the infection would no longer circulate in areas where the majority of children had been vaccinated.
This would leave unvaccinated children susceptible to contracting chickenpox as adults, when they’re more likely to develop a more severe infection or a secondary complication, or in pregnancy, when there’s a risk of the infection harming the baby.
We could also see a significant increase in cases of shingles in adults.
When people get chickenpox, the virus remains in the body. This can then reactivate at a later date and cause shingles.
Being exposed to chickenpox as an adult boosts your immunity to shingles.
If you vaccinate children against chickenpox, you lose this natural boosting, so immunity in adults will drop and more shingles cases will occur.
Why Not Just Let My Child Be Naturally Exposed To Chickenpox
Some parents concerned about the safety of the chickenpox vaccine throw chickenpox parties to purposely expose their children to chickenpox as toddlers, since it is much less serious at a younger age than in older children and adults. There are two problems with this reasoning:
- As we have mentioned above, chickenpox can be serious in some children, even though it is usually a mild, weeklong nuisance. Some children can get severe complications, such as pneumonia, encephalitis, overwhelming bacterial infections, and there have been around a hundred deaths reported from chickenpox. It is a nuisance and risk that children no longer need to endure.
- Because so many children are now receiving the vaccine as part of their routine immunizations , there are fewer children around to naturally expose unvaccinated children. So, as VV becomes more widely used, the chance of your child getting chickenpox naturally becomes less.
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People Who Should Be Immunised Against Chickenpox
People who benefit most from immunisation include:
- adults not immune to chickenpox , especially parents with young children and people in ‘at-risk’ occupations such as teachers, childcare workers and healthcare workers
- adults and young children who are not immune , and who live with people with weakened immune systems and no history of chickenpox.
Less Common And Serious Or Severe Adverse Events
Serious adverse events are rare following immunization and, in most cases, data are insufficient to determine a causal association. Anaphylaxis following vaccination with varicella-containing vaccine may occur but is very rare.
Univalent varicella vaccine
Most reported serious adverse events have not been proven to be caused by the vaccine, with the exception of rare events linked to the varicella vaccine strain among immunocompromised individuals or those with other serious medical conditions.
Immune Thrombocytopenic Purpura
Rarely, ITP occurs within 6 weeks after immunization with MMRV vaccine. In most children, post-immunization thrombocytopenia resolves within 3 months without serious complications. In individuals who experienced ITP with the first dose of MMRV vaccine, serologic status may be evaluated to determine whether an additional dose of vaccine is needed for protection. The potential risk to benefit ratio should be carefully evaluated before considering vaccination in such cases.
Encephalitis has been reported in association with administration of measles vaccine in approximately 1 per million doses distributed in North America, which is much lower than the incidence observed with natural measles disease .
Varicella zoster immunoglobulin
There is a remote risk of an anaphylactic reaction to VarIg in individuals with hypersensitivity to blood products.
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Who Needs Chickenpox Vaccine
Children under age 13 years should get two doses
- First dose at age 12 through 15 months
- Second dose at age 4 through 6 years
The second dose may be given at an earlier age if it is given at least 3 months after the first dose.
People 13 years of age and older who have never had chickenpox or received chickenpox vaccine should get two doses, at least 28 days apart. Chickenpox vaccination is especially important for:
- Healthcare professionals
Also, see Getting Vaccinated After You Are Exposed to Chickenpox.
What Is The Cause Of Chickenpox
contagious — over 90% of nonimmune individuals will develop chickenpox following exposure. VZV is communicable by both direct skin-to-skin contact and via respiratory droplets from the infected individual. While the average incubation period from viral exposure to onset of symptoms is 12-14 days, symptoms may appear as early as 10 days or as late as 21 days after exposure to the virus.
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Concerns About Side Effects
If a side effect following immunisation is unexpected, persistent or severe, or if you are worried about yourself or your child’s condition after immunisation, see your doctor or immunisation nurse as soon as possible or go directly to a hospital. It is important to seek medical advice if you are unwell, as this may be due to other illness, rather than because of the immunisation. Immunisation side effects may be reported to the Victorian vaccine safety service, the central reporting service in Victoria on 1300 882 924, select option one. You can discuss with your immunisation provider how to report adverse events in other states or territories.
At What Age Do Kids Get The Chickenpox Vaccine
The chickenpox vaccine is part of the childhood immunization schedule. Healthcare providers give the chickenpox vaccine in two doses. Your child should receive their first dose between the ages of 12 months and 15 months. They should receive their second dose between the ages of 4 and 6 years old.
Your childs healthcare provider may give your child the varicella vaccine at the same time as other vaccines. Children between the ages of 12 months and 12 years can receive the varicella vaccine together with the MMR vaccine. At 12 to 15 months, the chickenpox vaccine and MMR vaccine are usually given separately. At 4 to 6 years old, these two vaccines are often given as a single shot known as MMRV.
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Who Should Not Get The Vaccine
Children should not receive the vaccine if they:
- have allergies to the vaccine or any component of the vaccine
- have already had chicken pox
- had an anaphylactic reaction to a prior dose of the vaccine.
Special consideration is needed for children with weakened immune systems or those on medications to suppress their immune system.
Pregnant women should not be vaccinated.
You should always discuss the benefits and risks of any vaccine with your doctor/nurse practitioner or local public health unit.
Who Is Eligible To Receive The Publicly Funded Vaccine
Children who were born on or after January 1, 2000 are eligible to get two doses of the publicly funded vaccine.
People with medical conditions that put them at increased risk for complications due to chicken pox will also be eligible:
- children and adolescents given chronic salicylic acid therapy
- people with cystic fibrosis
- immunocompromised individuals – this should be determined on an individual basis. The vaccine is recommended for some immunocompromised persons, but contraindicated for others. Please discuss this with your doctor.
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Common And Local Adverse Events
Univalent varicella vaccine
Reactions to univalent varicella vaccine are generally mild and include injection site pain, swelling and redness in 10% to 20% of recipients. A low-grade fever has been documented in 10% to 15% of vaccine recipients. A varicella-like rash occurs at the injection site or is generalized in 3% to 5% of vaccine recipients after the first dose. The rash usually appears within 5 to 26 days after immunization. As varicella-like rashes that occur within the first 2 weeks after immunization may be caused by wild-type virus , health care providers should obtain specimens from the vaccine recipient to determine whether or not the rash is due to a natural varicella infection or to the vaccine-derived strain.
The safety profile of a 2 dose regimen is comparable to that of a single dose with slightly higher incidence of injection site reactions observed within 3 days after vaccination and slightly lower incidence of fever and varicella-like rash after dose 2 compared to dose 1.
Varicella zoster immunoglobulin
Reactions to VarIg are rare. The most frequent treatment related adverse events are pain at the injection site , headache , and rash .
Who Should Get The Chicken Pox Vaccine
The chicken pox vaccine is part of the routine vaccinations given across the country, but when your kid receives it depends on your provinces program schedule. In all the provinces and territories, except for Ontario and Nunavutwhere your kid would get the shot at 15 monthsthe first dose is given at 12 months. The timing of the second dose variesfor example, if youre from Quebec or Saskatchewan, the second dose would be administered at 18 months. If you live in Manitoba, shot number two is given between ages four and six. You can find your schedule at CANImmunize.ca.
Both doses of the vaccine are publicly funded across Canada, and Nicole Le Saux, professor of infectious diseases at the University of Ottawa and chair of the Canadian Paediatric Societys Infectious Diseases Committee, says all kids should be vaccinated, except for a few instances where its not recommended. We dont give it to people who have had bone marrow transplants people who have immunodeficiency problems, Le Saux says. This is because the vaccine is liveits a weakened version of the virus, and those with weakened immune systems cant produce the antibodies to fight it.
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Could My Child Simply Have A Blood Test To See If Hes Immune To Chickenpox Before Getting The Vaccine
Yes. This alternative approach is wise in teens and adults who have never had chickenpox. Studies show that the great majority of adults who dont remember ever having had chickenpox actually are immune to the disease. If as a teen or adult you dont remember ever having had chickenpox, it would be wise to ask your doctor about having a blood test to see if you are immune to the disease. If you arent, you should consider getting the VV vaccine. Around 70 to 90 percent of persons over eighteen years of age who dont remember ever having had chickenpox will be immune, so it is cost-effective to have a varicella titer, which is much less expensive than two doses of the vaccine. Yet, if you dont want to have the blood test and would rather get the vaccine, there is no increased severity of reactions in already immunized persons.
If I Want The Chickenpox Vaccine For My Child Can I Get It Free On The Nhs
Chickenpox vaccinations are provided free on the NHS where there’s a clinical need, such as for healthy people who are not immune to chickenpox and are in close contact with someone who has a weakened immune system.
This is to reduce the risk of the person with a weakened immune system catching chickenpox and then developing serious chickenpox complications.
Examples of children who’d probably be eligible for a chickenpox jab on the NHS include the brothers and sisters of a child with leukaemia, or a child whose parent is undergoing chemotherapy.
You cannot get the chickenpox vaccine free on the NHS if you simply want to prevent your child catching chickenpox and there are no other associated health risks.
A number of private travel clinics offer chickenpox vaccinations.
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Who Should Get Immunised Against Chickenpox
Anyone who wants to protect themselves against chickenpox can talk to their doctor about getting immunised.
Chickenpox immunisation is recommended for:
- children at age 18 months, for free under the National Immunisation Program
- children under 14 years old who have had one dose of chickenpox vaccine but want to get a second dose to further reduce their risk of disease
- children, teenagers and adults who have not had either the chickenpox disease or the chickenpox vaccine
- women who are planning to get pregnant and have not had either the disease or the vaccine
- children and adults who have not had either the disease or the vaccine and have been in contact with a person who has chickenpox in the past 5 days
- those who have contact with people who have weakened immune systems
- healthcare workers who have not had either chickenpox disease or 2 doses of the vaccine
- people working in early childhood education and care who have not had either the disease or 2 doses of the vaccine
- people working in long-term care who have not had either the disease or 2 doses of the vaccine.
People under 20 years old, refugees and other humanitarian entrants of any age, can get chickenpox vaccines for free under the NIP. This is if they did not receive the vaccines in childhood. This is called a catch-up vaccination. If they have already had chickenpox disease, they do not need a chickenpox vaccine.
When Babies Get Chickenpox
Last December, when my youngest child was just 3 months old, I got a call from my sister about her 4-year-old son. “Alex may have chickenpox,” she said. My heart sank. Since my son, Christopher, was born right near the start of cold and flu season, I’d been diligent about keeping him away from people, especially other children, as much as possible. And that was no easy feat, considering that I also have two schoolage kids. Just a few days earlier, though, my sister and her kids, including Alex, had stopped by. My 5- and 7-year-olds had been vaccinated against chickenpox but Christopher was too young to have gotten the shots. Could my new little guy be at risk? I quickly got off the phone with my sister and dialed my pediatrician’s office.
As it turns out, I needn’t have worried so much. “Chickenpox in babies is uncommon,” says Mary Anne Jackson, M.D., division director, infectious disease at Children’s Mercy Hospitals and Clinics in Kansas City, Missouri, and member of the American Academy of Pediatrics’ committee on infectious disease. “If the baby’s mother had chickenpox, or the chickenpox vaccine, then the infant is protected by maternal antibodies, which persist for several months.” The vast majority of moms — including me — fall into that category. “Only 2 percent of people have not had the natural virus or been immunized against it,” says Dr. Jackson.
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