The other day the mom of one of my ten-month-old patients called and asked, “What do you think about me taking him to a chicken pox party instead of getting the vaccine?” This is a question that comes up occasionally, and has a clear, easy answer. Don’t do it! Vaccinate your kids against varicella. Here’s why.
- Varicella can be a serious illness. A lot of us remember having chicken pox as a child and coming out of it relatively unscathed. So, why the vaccine? There are a number of reasons. The truth is that varicella varies greatly in severity. It is most often a relatively mild febrile illness with a rash. But it can also cause pneumonia, dehydration, severe skin infection, and encephalitis. About 1 in 500 unvaccinated children who are infected with varicella will need care in the hospital. During the pre-vaccine era, about 100 people died each year from this disease. Why take this kind of risk by intentionally exposing your child?
- There are some people for whom varicella is particularly dangerous. Very young infants and adolescents/adults are more likely to have complications from varicella than school age children. A woman who contracts varicella early in pregnancy can pass the virus to her fetus, which leads to small risk of congenital varicella syndrome. If a baby is born around the time that its mother has chicken pox, it can develop neonatal varicella infection. Finally, immunocompromised children or adults, such as those with leukemia or HIV, are at particular risk for severe course or complications from the illness.
This is why the vaccine was developed. We protect ourselves, our children, and our communities.
- The varicella vaccine has been recommended for use in the United States since 1995. Since 2006 we have been giving the first dose between 12-18 months, and a “booster” prior to school entry. Two doses are recommended because it has been found that while the majority of people are immune to varicella after one vaccination, the rate of immunity approaches 100% after the second dose. Older children and adults who have not had chicken pox or the vaccine should also be immunized. If you have a weakened immune system due to illness or medication, talk with your doctor about whether you are a candidate for vaccination.
- The varicella vaccine works. Prior to widespread use of the varicella vaccine, there were 3-4 million cases in the United States each year. Just last week the CDC released figures showing that there was an 80% decline in cases between 2000-2010, with the steepest decline occurring after the two vaccine regimen began. This is a remarkable success.
- The varicella vaccine is much safer than getting the illness. The majority of children or adults who get the vaccination have only minor pain at the injection site. Like any immunization or medication, there is a risk of side effects, but in this case more serious side effects are extremely rare. Approximately 5% of children will have a rash 1-3 weeks after receiving the vaccination. This rash is typically quite mild (2-10 lesions total) and resolves on its own.
So, please, vaccinate your family against varicella. Please don’t send your kids to a “pox party” or, even worse, give them a “pox pop.” You’ll save your family a week of general miserableness, or worse. Your child will miss less school. You’ll help to protect members of your community who cannot receive the immunization, some of whom would potentially become quite sick if exposed.
For more information, check out these great sites.
My Two Hats 
Well put. Thanks for another resource that we can use when discussing vaccines with our patients.
Thanks Dr. Kardos!
Clear and succinct. Glad there is a sensible pro-vaccination article on the web in contrast to the non-evidence based arguments that are frequently posted by others. Danielle
Thanks, Danielle. Glad you found it useful.
Any thoughts of the increase in Shingles among the adult population and the chicken pox vaccination? Shingles used to be known as an “old person’s” disease, but I know so many people in their thirty’s that are getting it.
JC, Interesting question. Here is what I can tell you:
-Per the CDC there are about 1 million cases of shingles per year. About half of these cases occur in adults older than 60, but shingles can occur even in children. I cannot find any evidence to support your thought that there is a true overall “increase” in the incidence of Shingles in the adult population in the US over the past decade. I would be surprised if this were the case, given that adults over 60 are now being immunized against shingles, and the vaccine has been shown to be effective in preventing disease.
-It is true that both wild-type varicella and live-attenuated (i.e. vaccine) form varicella can later reactivate to cause zoster/shingles. There is one large study that I could find of young adults who were vaccinated with varicella vaccine as children, and then followed to see if they developed shingles. They found that the overall incidence of shingles in this vaccinated cohort is quite low, and is similar to published data for the pre-vaccine era. Hope this helps.
this is great, heidi!
Thanks so much, Stevo. Fun to see you here. Thanks for reading!
I am trying to raise awareness, following the death of my daughter, Elana. She was a healthy 3 year old not immuno compromised in any way.
If the UK government/health professionals gave parents this type of information we could opt for a private vaccine, as it is still not available on the NHS (why???). At a cost of approx £100 my daughter would still be alive today. How can parents make an informed choice about their child’s health if we are denied the information?
Thank you
Angie
See YouTube – Elana Bunce-Mason for my daughters story.
I’m so very sorry for your loss, Angie. Thank you for sharing your story.
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my sons both received the vaccine at 12 months and the booster at 18months. One son, got a mild version of the pox last year. This is very common – kids who are vaccined, getting a mild version. While it was not as bad as a full version of course – it concerns me about the potency of the vaccine. Will they get a full-blown version by age 30?
Do you have any thoughts on this? And medical research on this aspect of it? The vaccine is only 10 years old so do we know enough to be hanging our hats it as a 100% effective vaccine throughout a person’s life?
thank you.
Hi Rachel, Good questions! We know that for varicella, like many other immunizations, our protective immunity tends to wane over time. This means that our body “forgets” a bit about varicella and needs a reminder in the form of a booster shot. In addition, as mentioned in the post, some people require two doses to build up good immunity in the first place. The AAP recommends the first dose of varicella at 12 months and the second dose is typically given between 4-5 years of age. Studies in the US have shown protection for at least 8 years. Other studies in Japan showed protection up to 20 years. It is, however, a relatively newer vaccine and there will be on-going research to determine whether further “boosters” are needed (as is done with other immunizations like pertussis). I would say that, based on the available evidence thus far, a person who has received the vaccine and appropriate booster is much less likely to get the full blown version of varicella than someone who has not.
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