What’s the Big Deal About Chickenpox?

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I presume that many of you just received the same notification that I got in my children’s school newsletter regarding Nebraska’s new 2011-2012 School Year Immunization Law. For any parents who may have missed it: in short, the state of Nebraska will soon require all students (K-12) to have two immunizations (instead one) for Varicella (Chickenpox) unless they provide written documentation verifying prior varicella infection. In keeping with Nebraska’s current immunization laws, children won’t be allowed to attend classes in public or private school until the school has written proof of either prior chickenpox infection or the required two varicella shots.

The update in Nebraska’s Immunization Law, with its increased requirement from one to two doses of chickenpox vaccine, came as no surprise to me since I make it a point to keep current on the latest immunization recommendations. That said, I have found that parents have had many questions about the chickenpox vaccine ever since it first became available in the US over 15 years ago. I figured it might therefore be useful to address some of the questions I’m most frequently asked about chickenpox and the vaccine.

What’s the big deal about just getting chicken pox? Let me first say that I fully understand the temptation for parents to consider chickenpox a not-such-a-big-deal childhood infection. After all, it is usually mild and self-limited – known primarily for being highly contagious and causing an itchy rash, fever and maybe some accompanying fatigue. What I have found, however, is that parents are often unaware of the fact that prior to the vaccine, chickenpox was also responsible for about 11,000 hospitalizations and 100 deaths in the US every year. Young children and adults were (and still are) more likely to develop serious symptoms as chickenpox infection can lead to severe skin infection, scarring, pneumonia, and even brain damage or death. In other words, chickenpox can be a very big deal.

Does the chickenpox vaccine work? Yes. The chickenpox vaccine does work to prevent chickenpox, as most people who get the vaccine will not get chickenpox. In fact, a single shot is estimated to be 80 to 90 percent effective. That said, it is possible to get chickenpox after having been vaccinated. Less than an estimated 1 to 3 percent of vaccinated children each year develop a mild varicella-like syndrome involving fewer blisters, less likelihood of fever, and shorter duration of symptoms.

Can you get chickenpox from the shot? While most people who get the chickenpox vaccine don’t have any problems with it, according to the CDC’s Chickenpox Vaccine Information Statement approximately 1 in 25 may develop a mild rash up to a month after getting the vaccine. While it’s possible for people with this rash to infect others, it’s extremely rare.

Why are two chickenpox shots needed instead of just one? Like a majority of other vaccines, it has been determined that chickenpox requires a second shot in order to provide adequate immunity. It is true that when chickenpox vaccine was first introduced in the US in 1995, it was initially recommended as a single shot (between the ages of 12 and 15 months). In 2006, however, the Advisory Committee on Immunization Practices recommended adding a second dose (between the ages of 4 and 6) after outbreaks were seen in previously vaccinated school-age children.

While I understand the temptation to cringe at the thought of yet one more shot added to our children’s already immunization schedule, I would like to suggest that we remember to be grateful for the fact that we have available to us a chickenpox vaccine that is much safer than getting the disease itself.

Originally posted on Omaha World Herald’s Live Well Nebraska