Chickenpox primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Aysha Aslam, M.B.B.S[2]

Overview

Vaccination is recommended for children as well as adults who have not been vaccinated previously to prevent chickenpox. Two doses of chickenpox vaccine are recommended for children who never have contracted chickenpox.The first dose is recommended between 12-15 months of age. The second dose is recommended around 4-6 years of age and also it may be given earlier if the gap between the doses is at least three months from the first dose. In adolescents and adults, a vaccine is recommended for people who are 13 years of age or older. There should be a gap of at least 28 days between the two doses.

Primary Prevention

Vaccination

A varicella vaccine has been available since 1995 to inoculate against the disease. Some countries require the varicella vaccination or an exemption before entering elementary school. Protection is not lifelong and further vaccination is necessary five years after the initial immunization.[1]

Varicella containing vaccines Indications Efficacy and immunogenicity Recommended dose Contraindications
Varicella vaccine (Varivax)[2][3][4][5]

Children

  • Routine vaccination at 12-15 months of age
  • Routine second dose at 4-6 years of age

Adolescents and Adults

  • 97% of children 12 months through 12 years following 1 dose
  • 99% of persons 13 years and older after 2 doses
  • 70% to 90% effective against any varicella disease
  • 90%-100% effective against severe varicella disease

Children

  • Minimum interval between doses of varicella vaccine is 3 months for children younger than 13 years of age

Adolescents and Adults

  • 2 doses separated by at least 4 weeks
  • Do not repeat the first dose because of extended interval between doses
Measles-mumps-rubella-varicella vaccine (ProQuad)[2]
  • Approved for children 12 months through 12 years
  • It should not be used for persons 13 years and older
  • May be used for both first and second doses of MMR and varicella vaccines
  • Minimum interval between doses is 3 months

References

  1. Chaves SS, Gargiullo P, Zhang JX; et al. (2007). "Loss of vaccine-induced immunity to varicella over time". N Engl J Med. 356 (11): 1121&ndash, 9. PMID 17360990.
  2. 2.0 2.1 http://www.cdc.gov/vaccines/pubs/pinkbook/varicella.html Accessed on October 24, 2016
  3. Centers for Disease Control and Prevention (CDC). Prevention of varicella: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1996;45(No.RR-11)
  4. Goldman, GS (2005). "Universal varicella vaccination: efficacy trends and effect on herpes zoster". International Journal of Toxicology. 24 (4): 205–213. PMID 16126614.
  5. Brisson M, Gay N, Edmunds W, Andrews N (2002). "Exposure to varicella boosts immunity to herpes-zoster: implications for mass vaccination against chicken pox". Vaccine. 20 (19–20): 2500–7. PMID 12057605.
  6. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5903a1.htm Accessed on October 24, 2016

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