Chickenpox primary prevention: Difference between revisions

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Latest revision as of 20:53, 29 July 2020

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.^[1]

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)^[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 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)^[2]	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^[6]	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

↑ 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.
↑ ^2.0 ^2.1 http://www.cdc.gov/vaccines/pubs/pinkbook/varicella.html Accessed on October 24, 2016
↑ 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)
↑ Goldman, GS (2005). "Universal varicella vaccination: efficacy trends and effect on herpes zoster". International Journal of Toxicology. 24 (4): 205–213. PMID 16126614.
↑ 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.
↑ http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5903a1.htm Accessed on October 24, 2016

Template:WikiDoc Sources

[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.

[CDC3-2] 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.

[CDCmmrv-6] ttp://www.cdc.gov/mmwr/preview/mmwrhtml/rr5903a1.htm Accessed on October 24, 2016

[1]

[2]

[3]

[4]

[5]

[6]

@@ Line 2: / Line 2: @@
 {{Chickenpox}}
 {{CMG}}; {{AA}}
+== Overview==
+[[Vaccination]] is recommended for children as well as adults who have not been [[Vaccination|vaccinated]] previously to prevent [[chickenpox]]. Two doses of [[Varicella vaccine|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 [[Adolescent|adolescents]] and [[Adult|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.<!--
+A [[varicella vaccine]] has been available since 1995 to [[Inoculation|inoculate]] against the [[disease]].  Some countries require the [[Varicella vaccine|varicella vaccination]] or an exemption before entering elementary school. Protection is not lifelong and further [[vaccination]] is necessary five years after the initial [[immunization]].<ref>{{cite journal | author=Chaves SS, Gargiullo P, Zhang JX, ''et al.'' | title=Loss of vaccine-induced immunity to varicella over time | journal=N Engl J Med | year=2007 | volume=356 | issue=11 | pages=1121&ndash;9 | id=PMID 17360990}}</ref>
-  --><ref>{{cite journal | author=Chaves SS, Gargiullo P, Zhang JX, ''et al.'' | title=Loss of vaccine-induced immunity to varicella over time | journal=N Engl J Med | year=2007 | volume=356 | issue=11 | pages=1121&ndash;9 | id=PMID 17360990}}</ref>
+* [[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 [[Adolescent|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 [[Chickenpox|varicella disease]] or received 2 doses of [[varicella vaccine]].
-In the UK, varicella antibodies are measured as part of the routine of prenatal care, and by 2005 all NHS healthcare personnel had determined their immunity and been immunised if they were non-immune and have direct patient contact.  Population-based immunization against varicella is not otherwise practiced in the UK, because of lack of evidence of lasting efficacy or public health benefit.
+{| align="center" style="border: 0px; font-size: 90%; margin: 3px;"
-{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
 |+
 ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Varicella containing vaccines}}
@@ Line 18: / Line 21: @@
 ! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF|Contraindications}}
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" | '''Varicella vaccine (Varivax)'''<ref name=CDC3>http://www.cdc.gov/vaccines/pubs/pinkbook/varicella.html Accessed on October 24, 2016</ref><ref>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)</ref><ref>{{cite journal | first=GS|last=Goldman| title=Universal varicella vaccination: efficacy trends and effect on herpes zoster | journal=International Journal of Toxicology| volume=24| issue=4 | year=2005 | pages=205-213 | id=PMID 16126614}}</ref><ref>{{cite journal | author = Brisson M, Gay N, Edmunds W, Andrews N | title = Exposure to varicella boosts immunity to herpes-zoster: implications for mass vaccination against chicken pox. | journal = Vaccine | volume = 20 | issue = 19-20 | pages = 2500-7 | year = 2002 | id = PMID 12057605}}</ref>
+| style="padding: 5px 5px; background: #DCDCDC;" | '''Varicella vaccine (Varivax)'''<ref name="CDC3">http://www.cdc.gov/vaccines/pubs/pinkbook/varicella.html Accessed on October 24, 2016</ref><ref>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)</ref><ref>{{cite journal | first=GS|last=Goldman| title=Universal varicella vaccination: efficacy trends and effect on herpes zoster | journal=International Journal of Toxicology| volume=24| issue=4 | year=2005 | pages=205-213 | id=PMID 16126614}}</ref><ref>{{cite journal | author = Brisson M, Gay N, Edmunds W, Andrews N | title = Exposure to varicella boosts immunity to herpes-zoster: implications for mass vaccination against chicken pox. | journal = Vaccine | volume = 20 | issue = 19-20 | pages = 2500-7 | year = 2002 | id = PMID 12057605}}</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" |
 '''Children'''
-*Routine vaccination at 12-15 months of age
+*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
+*All persons 13 years of age and older without evidence of [[Chickenpox|varicella]] [[immunity]]
 | style="padding: 5px 5px; background: #F5F5F5;" |
-*Detectable antibody
+*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
+:*70% to 90% effective against any [[Chickenpox|varicella]] disease
-:*90%-100% effective against severe varicella disease
+:*90%-100% effective against severe [[Chickenpox|varicella]] disease
 | style="padding: 5px 5px; background: #F5F5F5;" |
 '''Children'''
-*Minimum interval between doses of varicella vaccine is 3 months for children younger than 13 years of age
+*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 first dose because of extended interval between doses
+*Do not repeat the first dose because of extended interval between doses
 | style="padding: 5px 5px; background: #F5F5F5;" |
-*Severe allergic reaction to vaccine component or following a prior dose
+*Severe [[allergic reaction]] to [[vaccine]] component or following a prior dose
-*Immunosuppression
+*[[Immunosuppression]]
-*Pregnancy
+*[[Pregnancy]]
 *Moderate or severe acute illness
-*Recent blood product
+*Recent [[blood product]]
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" |'''Measles-mumps-rubella-varicella vaccine (ProQuad)'''<ref name=CDC3>http://www.cdc.gov/vaccines/pubs/pinkbook/varicella.html Accessed on October 24, 2016</ref>
+| style="padding: 5px 5px; background: #DCDCDC;" |'''Measles-mumps-rubella-varicella vaccine (ProQuad)'''<ref name="CDC3">http://www.cdc.gov/vaccines/pubs/pinkbook/varicella.html Accessed on October 24, 2016</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" |
 *Approved for children 12 months through 12 years
-*Do not use for persons 13 years and older
+*It should not be used for persons 13 years and older
 | style="padding: 5px 5px; background: #F5F5F5;" |
-*Efficacy of MMRV vaccine was inferred from that of MMR vaccine and varicella vaccine on the basis of noninferior immunogenicity
+*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<ref name=CDCmmrv>http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5903a1.htm Accessed on October 24, 2016</ref>
+*Formal studies to evaluate the clinical efficacy of [[MMRV vaccine]] have not been performed<ref name="CDCmmrv">http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5903a1.htm Accessed on October 24, 2016</ref>
 | style="padding: 5px 5px; background: #F5F5F5;" |
-*May be used for both first and second doses of MMR and varicella vaccines
+*May be used for both first and second doses of [[MMR]] and [[Varicella vaccine|varicella vaccines]]
 *Minimum interval between doses is 3 months
 | style="padding: 5px 5px; background: #F5F5F5;" |
-*Severe allergic reaction to vaccine component or following a prior dose
+*Severe [[allergic reaction]] to [[vaccine]] component or following a prior dose
-*Immunosuppression
+*[[Immunosuppression]]
-*Pregnancy
+*[[Pregnancy]]
 *Moderate or severe acute illness
-*Recent blood product
+*Recent [[blood product]]
-*Personal or family (i.e., sibling or parent) history of seizures of any etiology
+*Personal or family (i.e., sibling or parent) history of [[Seizure|seizures]] of any etiology
 |-
 |}
-====Normal Reactions to Vaccine====
-*Fever of 101.9 (38.9 C) up to 42 days after Injection
-*Soreness, inching at the site of injection within 2 days
-*Rash occurring at site of injection anywhere form 8 to 19 days after injection. If this happens you are considered contagious.
-*Rash on other parts of body anywhere from 5 to 26 days after injection. If this happens you are considered contagious.
-====What to do Should Reaction Occur?====
-Control fever and lessen discomfort, take medication containing [[acetaminophen]], (AKA paracetamol) such as
-*[[Panadol]],
-*Tempra,
-*[[Tylenol]].
-====Vaccine Storage====
-All varicella-containing vaccines should be stored in a continuously frozen state at the manufacturer recommended freezer temperature until administration. Varicella and zoster vaccines should be stored at +5°F (-15°C) or colder. The combination vaccine measles, mumps, rubella, and varicella (MMRV) should also be stored frozen between -58°F and +5°F (-50°C to -15°C). If varicella and zoster vaccines are stored in the freezer with MMRV, keep the temperature between -58°F and +5°F (-50°C to -15°C). Measles, mumps, rubella vaccine (MMR) can be stored either in the freezer or the refrigerator. When stored in the freezer, the temperature should be the same as that required for MMRV, between -58°F and +5°F (-50°C to -15°C). Storing MMR in the freezer with MMRV may help prevent inadvertent storage of MMRV in the refrigerator.
-CDC strongly discourages transport of varicella-containing vaccines to off-site clinics. All varicella-containing vaccines are fragile. If these vaccines must be transported to an off-site clinic, the vaccine manufacturer recommends they be trans322 Varicella 21 ported and stored at refrigerator temperatures, between 35°F and 46°F (2°C to 8°C), for no more than 72 continuous hours prior to reconstitution. Vaccine stored between 35°F and 46°F (2°C to 8°C) that is not used within 72 hours of removal from the freezer should be discarded. Varicella-containing vaccines cannot be refrozen. Providers should contact their immunization program for advice and details.
-Having a patient pick up a dose of vaccine (e.g., zoster vaccine) at a pharmacy and transporting it in a bag to a clinic for administration is not an acceptable transport method for zoster vaccine or any other vaccine. The vaccine diluent should be stored separately at room temperature or in the refrigerator. The vaccine should be reconstituted according to the directions in the package insert and only with the diluent supplied (or with the diluent supplied for MMR vaccine), which does not contain preservative or other antiviral substances that might inactivate the vaccine virus. Once reconstituted, all varicella containing vaccines must be used immediately to minimize loss of potency. The vaccine must be discarded if not used within 30 minutes of reconstitution. Mishandled varicella vaccine should be clearly marked and replaced in the freezer separate from properly handled vaccine. The manufacturer must be contacted for recommendations before any mishandled vaccine is used.
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