Chickenpox primary prevention

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

• Chickenpox vaccine became available in the United States in 1995. In 2014, 91% of children 19 to 35 months old in the United States had received one dose of varicella vaccine, varying from 83% to 95% by the state. Among adolescents 13 to 17 years of age without a prior history of the disease, 95% had received 1 dose of varicella vaccine, and 81% had received 2 doses of the vaccine. Eighty-five percent of adolescents had either a history of varicella disease or received 2 doses of varicella vaccine.

Varicella containing vaccines	Indications	Efficacy and immunogenicity	Recommended dose	Contraindications
Varicella vaccine (Varivax)	Children Routine vaccination at 12-15 months of age Routine second dose at 4-6 years of age Adolescents and Adults All persons 13 years of age and older without evidence of varicella immunity	Detectable antibody 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	Severe allergic reaction to vaccine component or following a prior dose Immunosuppression Pregnancy Moderate or severe acute illness Recent blood product
Measles-mumps-rubella-varicella vaccine (ProQuad)	Approved for children 12 months through 12 years It should not be used for persons 13 years and older	Efficacy of MMRV vaccine was inferred from that of MMR vaccine and varicella vaccine on the basis of non-inferior immunogenicity Formal studies to evaluate the clinical efficacy of MMRV vaccine have not been performed	May be used for both first and second doses of MMR and varicella vaccines Minimum interval between doses is 3 months	Severe allergic reaction to vaccine component or following a prior dose Immunosuppression Pregnancy Moderate or severe acute illness Recent blood product Personal or family (i.e., sibling or parent) history of seizures of any etiology

References

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