QUESTION: Isn't chickenpox just a harmless disease of childhood?

ANSWER: Chickenpox is the leading cause of vaccine-preventable deaths of children in the USA. Every year in the US, varicella causes:

• 3.9 million cases of VZV, 90% in children 1 to 12 years old.
• 364,000 visits to the doctor .
• Nearly 10,000 hospitalizations of children.
• About 100 deaths each year of children and adults .

QUESTION: Isn't immunization through infection as safe as immunization through vaccination?

ANSWER: Chickenpox can lead to complications that include:

• Secondary bacterial infection - the most common complication in children (impetigo, cellulitis, virulent streptococcus).
• Pneumonia - the most common complication for adults with VZV (11%); 2nd most common complication for children.
• Acute cerebellar ataxia (in 1:4,000 cases).
• Encephalitis (in nearly 1:50,000 cases

QUESTION: Does chickenpox have any lasting effects?

ANSWER: Aside from potential sequelae of complications, initial infection with VZV is followed by ongoing latent infection that can later erupt as shingles (zoster). Shingles, a painful disease that can last for up to a year, can damage the optic nerve and retina, and can also contribute to cataracts and glaucoma. Shingles occurs in about 1.3:1000 people who contract chickenpox.

QUESTION: Can children who are vaccinated still catch chickenpox?

ANSWER: Varivax, the varicella vaccine, provides 70-90% protection against breakthrough infection, and 95% protection against severe disease.

QUESTION: The chickenpox vaccine is still new -- could it have serious side effects?

ANSWER: No vaccine has ever had a longer series of clinical trials, beginning in the late 1970s. Side effects with Varivax are very mild.

QUESTION: Can a recently-vaccinated child give someone else chickenpox?

ANSWER: A child who develops a rash following Varivax vaccination may infect others who are not immune. Contact must be close, and must persist over several days, as occurs in a family. Due to the attenuated virus used in the vaccine, the resulting infection is usually very mild.

QUESTION: If a child has been exposed to VZV, is there any way to prevent infection?

ANSWER: Vaccination may prevent infection or significantly reduce its severity if given within 3 days of exposure.

QUESTION: Do adults need to be concerned if they get chickenpox?

ANSWER: Chickenpox is more severe in adults, who are 6 times more likely than children to have complications; 35 times more likely to die.

Infection during the first 20 weeks of pregnancy will cause congenital varicella syndrome (defects of muscle, bone, limbs, head; blindness, seizures, mental retardation) in 2-3% of unborn babies.

Perinatal infection in mothers who develop the rash from 5 days before to 2 days after delivery will infect 25% of their newborns; neonatal mortality can be as high as 30%.

QUESTION: Will the immunity created by the vaccine wear off over time?

ANSWER: Immunity has continued into adulthood in 94-100% of those tested in Japan, where the vaccine has been in use for more than 20 years. Current research in this country is arriving at similar conclusions.

QUESTION: Does vaccination with Varivax cause shingles?

ANSWER: Current research suggests that vaccination can reduce the incidence of shingles.

QUESTION: Should everyone be vaccinated?

ANSWER: Children should be vaccinated once they have passed their first birthday, unless the contraindications listed below are present. Children older than one year and younger than 12 years should receive a single dose of vaccine. Children 12 and older and adults need two doses, given 4 to 8 weeks apart.

Contraindications to immunization with Varivax include:

• Age of less than 12 months.
• Blood dyscrasias.
• Immunodeficiency disease, primary or secondary .
• Immunosuppressive therapy, steroid therapy, treatment with immune globulin in the past 5 months.
• Moderate/severe illness with fever, excluding URI, diarrhea, otitis media.
• Neomycin or gelatin allergy.
• Possible or confirmed pregnancy, intention to become pregnant within 3 months.
• TB, active, untreated