Chickenpox vaccine: Yes or no?

You scratched your way through the chickenpox as a child and lived to tell about it; why should you vaccinate your child against chickenpox? Now that vaccinating babies against this common childhood disease is becoming routine, many parents are asking that question.

Some have heard that the vaccine is not safe. In fact, the vaccine was tested on 11,000 children and adults before it received government approval in 1995. The "bad" reactions were generally mild and included symptoms such as a swollen arm, fever and rash.

There has also been concern about inoculating babies and children against the disease because it's uncertain how long the vaccine is effective. While chickenpox is usually mild in children, it can be much more severe and carry greater risk to adults. But in the five years since chickenpox vaccinations began, scientists so far can't find any evidence that immunity goes away.

Vaccination can keep your child and family from getting an annoying, uncomfortable disease that can have serious side effects. Although it's usually a mild disease, the Centers for Disease Control (CDC) estimates that there are 9,300 chickenpox-related hospitalizations and 50 to 100 deaths annually, mainly among young children. The vaccine is estimated to be 70 to 90 percent effective in preventing the disease.

If you decide to vaccinate, your baby should be inoculated at 15 months the first time and again between 4 and 6 years of age or before junior high school.

What is chickenpox?

It is a highly contagious disease spread from person to person by direct contact or though the air. Chickenpox has a characteristic itchy rash, which then forms blisters that dry and become scabs in four to five days. The rash may be the first sign of illness, sometimes coupled with fever and lack of energy.

What about infants exposed at birth?

A product called VZIG (pronounced "vee-zig") must be given to babies within 96 hours of exposure, long before symptoms appear. It can help prevent complications and speed recovery.

This product is made from the plasma of normal blood donors who have high levels of antibodies to the virus that causes chickenpox. The CDC recommends this product for newborns whose mothers come down with chickenpox five days before to two days after delivery and to premature babies exposed after birth.

Any resistance a mother has to the disease is passed on to the baby through the placenta and also through breast milk. But British doctors report that this immunity doesn't last.

Can vaccination cause shingles?

Shingles is called the "second act" of chickenpox. Once you get chickenpox, the virus becomes dormant in your body but doesn't die. For unknown reasons, the virus reawakens in some people and infects nerve fibers. Shingles can cause severe pain and itching. It usually emerges after age 50.

Since the chickenpox vaccine was introduced in 1995 it isn't known yet whether it will cause shingles at the same rate in vaccinated people as in people who have been infected with the virus. There is some preliminary evidence that suggests the vaccine may reduce the likelihood of shingles over the short term. But more studies are needed.

It takes two shots

Scientists don't know why one shot isn't enough, but two are needed. In young children, the vaccine is administered at the same time as the measles, mumps and rubella (MMR) vaccine (at 15 months and again between ages 4 and 6 or before junior high).

Date last reviewed: October 2002.

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