Getting Vaccinated After You Are Exposed to Chickenpox
Childcare and School Chickenpox Vaccine Requirements
How Can Parents Pay for Chickenpox Vaccine?
How to Pronounce Varicella media icon[MP3]
At a Glance
Chickenpox is a highly contagious disease caused by the varicella-zoster virus (VZV). It causes an itchy, blister-like rash. The rash appears first on the chest, back, and face, and then spreads over the entire body.
Chickenpox used to be very common in the United States. In the early 1990s, an average of 4 million people got chickenpox, 10,500 to 13,000 were hospitalized, and 100 to 150 died each year. Chickenpox vaccine became available in the United States in 1995. Each year, more than 3.5 million cases of chickenpox, 9,000 hospitalizations, and 100 deaths are prevented by chickenpox vaccination in the United States.
CDC recommends two doses of chickenpox vaccine for children, adolescents, and adults who have never had chickenpox and were never vaccinated. Children are routinely recommended to receive the first dose at 12 through 15 months of age and the second dose at 4 through 6 years of age.
Who Needs Chickenpox Vaccine
Children under age 13 years should get two doses
First dose at age 12 through 15 months
Second dose at age 4 through 6 years
The second dose may be given at an earlier age if it is given at least 3 months after the first dose.
People 13 years of age and older who have never had chickenpox or received chickenpox vaccine should get two doses, at least 28 days apart. Chickenpox vaccination is especially important for
People who care for or are around other people whose body is less able to fight germs and sickness (weakened immune system)
Residents and staff in nursing homes and other residential settings
Inmates and staff of correctional institutions
Non-pregnant women of child-bearing age
Adolescents and adults living with children
To check if you are protected from chickenpox, see Assessing Immunity to Varicella.
Some people with a weakened immune system who do not have immunity against chickenpox may be considered for vaccination after talking with their doctor, including people
with HIV infection
with cancer, but whose disease is in remission
on low dose steroids
For more information on vaccination of people with weakened immune systems, see Varicella Vaccination Recommendations for Specific Groups.
Also, see Getting Vaccinated After You Are Exposed to Chickenpox.
Who Should Not Get Chickenpox Vaccine
You do not need to get the chickenpox vaccine if you have evidence of immunity against the disease.
Some people should not get chickenpox vaccine or they should wait.
People should not get chickenpox vaccine if they have ever had a life-threatening allergic reaction to a previous dose of chickenpox vaccine or any ingredient of the vaccine, including gelatin or the antibiotic neomycin.
People who are moderately or severely ill at the time the shot is scheduled should wait until they recover before getting chickenpox vaccine.
Pregnant women should not get chickenpox vaccine. They should wait to get chickenpox vaccine until after they have given birth. Women should not get pregnant for 1 month after getting chickenpox vaccine.
People should check with their doctor about whether they should get chickenpox vaccine if they
Have HIV/AIDS or another disease that affects the immune system
Are being treated with drugs that affect the immune system, such as steroids, for 2 weeks or longer
Have any kind of cancer
Are getting cancer treatment with radiation or drugs
Recently had a transfusion or were given other blood products
Immune Conditions in Family Members
People should check with their doctor about whether they should get chickenpox vaccine if they have immune conditions in first degree relatives (parents, siblings) that can be inherited (called immunodeficiencies).
Most children who have family members with immune system problems can safely get varicella vaccine as long as they themselves have a healthy immune system.
Generally, anyone with a weakened immune system should not get live vaccines, such as chickenpox vaccine. Most immune system problems are not related to the patient’s family. They come from illnesses such as cancer, or from medications such as chemotherapy drugs.
There are some rare immune conditions that can run in the family. So children whose parents, brothers or sisters have one of these conditions should be screened before getting chickenpox vaccine to make sure they haven’t inherited it as well. Children with a family history of these conditions can get the chickenpox vaccine if they are found not to have the conditions themselves.
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Types of Chickenpox Vaccine
There are two chickenpox vaccines that are licensed in the United States—Varivax® and ProQuad®.
Contains only chickenpox vaccine
Is licensed for use in children age 12 months and older, adolescents, and adults
Can be given to children for their routine two doses of chickenpox vaccine at age 12 through 15 months and age 4 through 6 years.
Contains a combination of measles, mumps, rubella, and varicella (chickenpox) vaccines, which is also called MMRV
Is only licensed for use in children age 12 months through 12 years
ProQuad® can be given to children for their routine two doses of chickenpox vaccine at age 12 through 15 months and age 4 through 6 years. Children who get the first dose of MMRV at age 12 to 23 months may have a higher risk of a seizure caused by fever. This is in comparison to children who get the measles, mumps, and rubella vaccine and the chickenpox vaccine separately during a doctor visit. These seizures are not common. They may be scary for parents, but they are not harmful to children. Talk with a doctor if you have questions.
For more information, please see the following Vaccine Information Statements (VISs). VISs are information sheets produced by CDC that explain both the benefits and risks of a vaccine:
Chickenpox (Varicella) VIS
MMRV (Measles, Mumps, Rubella, and Varicella) VIS
Getting Vaccinated After You Are Exposed to Chickenpox
If you do not have immunity against chickenpox and are exposed to someone with this disease or shingles, talk with your doctor about getting chickenpox vaccine.
You should get chickenpox vaccine within three to five days of being exposed. Even if more than five days have passed since you were exposed, vaccination with two doses is still recommended to protect against future exposures if you were not infected. You need two doses of vaccine separated by minimum of 28 days.
For more information, see Who Needs Chickenpox Vaccine.
If you previously got one dose of chickenpox vaccine, you should get a second dose.
Getting vaccinated after you are exposed to someone with chickenpox can:
prevent the disease or make it less serious
protect you from chickenpox if you are exposed again in the future
A healthcare provider can prescribe a medicine to make chickenpox less severe if you:
are exposed to chickenpox,
do not have immunity against the disease, and
are not eligible for vaccination.
For more information, see Managing People at High Risk for Severe Varicella.
Also, see information about Who Should Not Get Chickenpox Vaccine.
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Childcare and School Chickenpox Vaccine Requirements
All 50 states and the District of Columbia (DC) have state laws that require children entering childcare or public schools to have certain vaccinations. There is no federal law that requires this.
The Advisory Committee on Immunization Practices recommends that all states require children entering childcare and students starting school, college, and other postsecondary educational institutions to have:
age-appropriate chickenpox vaccination
preschool-age children (age 12 months through 3 years): one dose
school-age children, adolescents, adults: two doses or
other evidence of immunity against chickenpox.
Students in school settings have a higher likelihood of spreading chickenpox because they are constantly in close contact with each other.
Chickenpox vaccine prevents the disease and outbreaks in childcare settings and schools. This leads to
less illness and less school time missed by students, and
less chance of exposing people who cannot get vaccinated.
For the 2020-2021 school year, all states (including the District of Columbia) require children to receive at least one dose of chickenpox vaccine or have other evidence of immunity against chickenpox before starting school, and 45 states require two doses of chickenpox vaccine.
For more information, see State Vaccination Requirements.
How Can Parents Pay for Chickenpox Vaccine?
Most health insurance plans cover the cost of vaccines. However, you may want to check with your insurance provider before going to the doctor. If you don’t have health insurance or if your insurance does not cover vaccines for your child, the Vaccines for Children (VFC) Program may be able to help. This program helps families of eligible children who might not otherwise have access to vaccines. To find out if your child is eligible, visit the VFC website or ask your child’s doctor. You can also contact your state VFC coordinator.
CDC Chickenpox Disease Website
Chickenpox Fact Sheet for Parents
Chickenpox: Questions and Answers, Immunization Action Coalitionexternal icon
Chickenpox Vaccine Information Statement
Combined Measles, Mumps, Rubella, and Varicella Vaccine Information Statement
Varicella (Chickenpox) – Preventive Measures for Travelers
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What women should know about chickenpox, vaccination, and pregnancy | Your Pregnancy Matters
Chickenpox may not be as common as it once was, but it can still present a risk to pregnant women who have not had the virus or the vaccine.
Before a vaccine became available in 1995, chickenpox was almost considered a childhood rite of passage. But while many people have tales of chickenpox parties – purposely infecting kids to “get it out of the way” – it’s important to remember this isn’t an entirely harmless disease. In the early 1990s, up to 13,000 people were hospitalized due to the virus and 100 to 150 people died each year.
It’s estimated that in the U.S., more than 3.5 million cases of chickenpox, 9,000 hospitalizations, and 100 deaths are prevented by the chickenpox vaccine each year. Chickenpox is still with us, and it can have devastating consequences, particularly for pregnant women and their babies.
In 2021, a woman in Illinois contracted chickenpox early in pregnancy and gave birth to a premature baby who died shortly after delivery. It was confirmed the baby had congenital varicella syndrome – chickenpox in utero.
The Centers for Disease Control and Prevention (CDC) recommends that all adults be assessed for immunity to chickenpox. So, don’t be surprised if your healthcare provider asks you about chickenpox if you are pregnant or are thinking about becoming pregnant. As always, we just want to keep you and your baby as safe and healthy as possible.
Potential complications of chickenpox in pregnancy
Chickenpox is a highly contagious disease caused by the varicella-zoster virus. Chickenpox generally causes an itchy, blister-like rash. But pregnant women are at risk for more serious complications, particularly pneumonia, because changes in the immune system during pregnancy make them more susceptible to infection.
Pregnant women also can pass the virus to their babies. Much like rubella or Zika, if a woman gets chickenpox in her first or early second trimester, the virus can cause birth defects. Symptoms of congenital varicella syndrome can include:
Arm and leg abnormalities
Low birth weight
Microcephaly, a condition in which a baby’s head is significantly smaller than expected
Scarring on the skin from chickenpox lesions
If a woman develops chickenpox shortly before going into labor, the newborn is at risk of being born with chickenpox. While such complications are rare, it’s important to take steps to prevent them, to be aware of their potential, and be on the lookout for chickenpox during pregnancy.
Are you at risk for chickenpox?
While the chickenpox vaccine has been around since 1995, there is still a population of women who are susceptible to the disease. This includes women who:
Didn’t have access to the vaccine, perhaps because they come from a country without a robust childhood immunization program
Were not vaccinated due to their parents’ choice
Thought they had chickenpox as children but actually didn’t
For the last several decades, about 90% of children have gotten vaccinated against chickenpox, which means 1 in 10 of our younger pregnant patients may not be immune to the virus.
If you don’t have documentation of being diagnosed with or vaccinated against chickenpox as a child, your healthcare provider may suggest blood testing to determine whether you have antibodies to the varicella-zoster virus. If you don’t, we recommend you get two doses of the chickenpox vaccine before pregnancy or after delivery.
If you were born before 1980, you are presumed to be immune to chickenpox due to the number of circulating viruses when you were young. However, women who are immunocompromised, pregnant, or a healthcare provider should get tested for antibodies due to increased risks of getting or spreading the virus if they do not have good records of having received the vaccine.
Related reading: Why we discuss vaccines, maternal health during pregnancy
Can you get the chickenpox vaccine during pregnancy?
The chickenpox vaccine contains a live attenuated (inactive) virus – similar to the measles, mumps, and rubella vaccine (MMR) – so you cannot get vaccinated if you are currently pregnant. However, we will strongly suggest you get a first dose of the vaccine after you give birth to protect you, your baby, and future pregnancies. The vaccine is safe for breastfeeding women and babies.
If you know you haven’t had chickenpox or the vaccine and you’re thinking about having a baby, talk to your healthcare provider about getting and finishing the vaccine series at least three months before you start trying to get pregnant. This is the best way to protect yourself and your baby from chickenpox.
Related reading: Which prenatal vitamins should I take?
One more note: The varicella vaccine also potentially protects you from shingles, another painful adult virus. Shingles is a reactivation of the chickenpox virus, and it can cause a painful rash along with headache, chills, upset stomach, and eye problems. If you’re vaccinated against chickenpox and never get the disease, you’re protected against shingles as well.
Chickenpox is not as common as it used to be, but it’s still around – and it’s still potentially dangerous. The good news is there are ways we can protect ourselves and our children. Talk with your healthcare provider about your chickenpox history and whether you should get the varicella vaccine before or after pregnancy.
For more information about the varicella vaccine and whether you need it, call 214-645-8300 orrequest an appointment online.
Should I get vaccinated if I'm trying to get pregnant?
Vaccines help protect against certain types of diseases by using weakened or dead bacteria and viruses that are given to the body through injections, nasal sprays, or tablets. Vaccines usually contain a small portion of a bacterium or virus in a softened but viable or dead form. For example, the varicella (chickenpox) vaccine is an injection that contains highly attenuated particles of the chickenpox virus. The virus in a vaccine is usually not strong enough to cause an infection, but it can stimulate the immune system to produce antibodies that can protect a person from future infections.
Why should I think about vaccinations if I'm interested in the question of conception?
Vaccination is designed to help prevent serious complications during the period of bearing a baby. For example, if an unvaccinated mother becomes infected with rubella during pregnancy, it can lead to miscarriage or serious birth defects in the unborn child. A common viral infection like the flu often also negatively affects both the mother and the baby. Getting the flu during pregnancy can lead to miscarriage, premature birth, pneumonia in the mother-to-be, or even death. Vaccination against these and other infections before pregnancy can protect the mother-to-be from getting the infection or prevent its serious consequences.
When is the best time to get vaccinated?
Some types of vaccination, such as hepatitis A or B, as well as the influenza virus, can be carried out even during pregnancy. Keep in mind that chickenpox or rubella vaccines contain weakened but live versions of viruses/bacteria and are best given one to three months before pregnancy. In any case, we advise you to consult with your doctor to make the right decision about the necessary vaccination.
What are the side effects of vaccination?
Most people experience little to no side effects after vaccination. However, sometimes after the vaccine is given, the patient may experience redness or swelling of the skin or muscle pain at the site of the intramuscular injection.
If you are allergic to certain drugs, certain foods, or other substances, discuss this with your doctor before getting vaccinated, as some vaccines may contain them.
I am taking corticosteroids to treat a medical condition that I have. Can I get vaccinated in this case?
Some vaccinations are not recommended for patients taking steroids or other drugs that affect the immune system. Be sure to discuss your situation with your doctor individually. At a consultation with a specialist, you must list all the drugs that you took before deciding to get vaccinated.
I'm planning a trip to Asia/Africa soon and trying to get pregnant at the same time. Should I get vaccinated?
Some diseases, such as jaundice or malaria, are more common outside of Russia. Certain viruses and infections can cause serious health problems for anyone, especially pregnant women. Some of the exotic disease vaccines are safe for use by pregnant women and women who are trying to get pregnant. But the advisability of vaccinations should definitely be discussed with a doctor who deals with the issue of vaccination of travelers.
Can vaccines cause autism or birth defects?
Currently, there is no medical evidence that vaccination can cause autism or other diseases in children whose mothers were vaccinated. Rather, on the contrary, the lack of proper vaccination can lead to serious health problems for both the mother and the child.
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The normative documentation of the Russian Federation and international recommendations were used to compile the answers.
Prevention of chicken pox is not a topic for distance consultation. The best solution is to contact a full-time specialist.
Why should I be vaccinated against chickenpox? Maybe it's better to get sick?
This is a dangerous delusion that has developed from the situation of the past years, when there was no vaccine against chickenpox in the USSR and Russia, and it was impossible to effectively prevent the disease. At the same time, varicella vaccines were developed abroad in the mid-70s, recommended for use in individual countries since the mid-80s, and have been widely used since the early 90s.
Chickenpox is not a harmless disease, a certain percentage of various complications are recorded, including those requiring subsequent hospitalization. Moreover, this is observed in children under the age of 15 with normal immunity. With age, the risk of complications and mortality can increase up to 50%, provided that the affected adult did not have chickenpox before or was not vaccinated. Often, secondary skin infection, pneumonia, varicella encephalitis, cerebellar ataxia, damage to the facial nerve, and eye damage are recorded as complications. Mortality averages 1 in 60,000.
In addition, in 10-20% of those who have been ill, the varicella-zoster virus remains in the nerve ganglia for life and subsequently causes another disease that can manifest itself at an older age - herpes zoster or herpes ( Herpes zoster ). Herpes zoster is characterized by prolonged and excruciating neuralgic pains, and also has a number of complications in the form of lesions of the nervous system and internal organs - paralysis, visual impairment. People with herpes zoster can be a source of chickenpox infection.
Chickenpox can also cause damage to the fetus or newborn when a woman develops chickenpox in the first 20 weeks of pregnancy or in the last days before delivery.
Vaccination against varicella in children and adults provides an opportunity to prevent these consequences.
What varicella vaccines are available in Russia?
Two varicella vaccines are registered in the Russian Federation.
Is it possible to get chickenpox from the chickenpox vaccine?
No. The vaccine uses a weakened virus.
There is a small risk of developing a post-vaccination infection in people with severe immunodeficiency (oncohematology, etc.), but in any case, vaccination of these people against chickenpox in developed countries is carried out as a standard procedure for preventing severe chickenpox.
At what age can you be vaccinated against varicella and how long does immunity last after vaccination?
According to the instructions for use, children can be vaccinated against varicella from the age of 12 months.
Having been vaccinated against chickenpox, is there a guarantee that the child will not get sick throughout his life?
100% - no. Cases of varicella-zoster virus infection in vaccinated individuals are estimated to be very rare, but mild to very mild varicella has been reported in this case, both in terms of general reactions (fever) and skin rashes ( a single number of emerging vesicles or their complete absence).
After what time after vaccination is the child no longer afraid to contact with chickenpox patients?
Immunity in vaccinated individuals begins to develop from the first day and is usually completed after 6 weeks.
Are there any reasons why varicella vaccination is contraindicated?
2). Primary and secondary immunodeficiency with a leukocyte level of less than 1200 cells / μl (for example, acute myeloid leukemia, T-cell leukemia, or malignant lymphoma).
A list of contraindications (temporary and permanent) is given in the instructions for the specific varicella vaccine.
Persons with elevated body temperature (from 37.5ºС and above, when measured in the armpit) - until the temperature and clinical picture normalize.
Persons with acute illness - up to 2-4 weeks after recovery. And in mild SARS, acute intestinal diseases, etc. - until the temperature returns to normal
In severe acute diseases of the nervous system, for example, meningococcal meningitis - before the expiration of a longer period (up to 6 months from the onset of the disease) after stabilization of residual changes.
During an exacerbation of a chronic disease before the onset of a complete or maximum achievable remission, including against the background of maintenance treatment (except immunosuppressive).
For an upcoming elective surgery within a month before the date of surgery.
When undergoing immunosuppressive therapy.
What are the adverse reactions after varicella vaccines?
Possible reactions are described in the instructions for use of the specific vaccine. Expected local reactions are pain or redness at the injection site; general reactions may include fever and malaise. Occasionally, healthy children and adults may develop a rash 1-3 weeks after vaccination. These symptoms usually disappear on their own within a few days.
As with any drug or food product, the introduction of vaccines can very rarely be accompanied by an allergic reaction.
How soon can pregnancy be planned after varicella vaccination?
After varicella vaccination, pregnancy should be avoided for 3 months.
If an adult did not have chickenpox as a child, should they be vaccinated?
Yes. Complications and mortality from chickenpox disease are the most common cause in adults than in children, the incidence of adults is 5% of cases, but it is in adults that deaths account for 35% (in adults, the fatality rate is 25 times higher than in children). It is also recommended to vaccinate women planning pregnancy and people in contact with sick immunodeficiency states (so as not to become a source of infection).
Conventional varicella vaccines are not used to vaccinate the elderly. In North America, a special ostavax vaccine is used to vaccinate the elderly against herpes zoster ( Herpes zoster ) (not available in the Russian Federation).
Is it possible to combine vaccination with varicella vaccine on the same day with other vaccines during routine vaccination?
Yes, except for the BCG vaccine. With routine vaccination on the same day as the varicella vaccine, you can administer any vaccine (in different places and with different syringes), excluding the BCG vaccine.
If the varicella vaccine has not been given at the same time as other vaccines, then inactivated (killed) vaccines can usually be given at any time, and other live vaccines no earlier than a month later.
Please refer to the instructions for use of specific vaccines for further information.
What is the emergency prophylaxis after contact with a patient with chickenpox?
Emergency vaccination in previously unill and unvaccinated persons may be effective within usually 72 hours after exposure (sometimes up to 96 hours).
But even after more time, it is recommended to be vaccinated, because in this case the chickenpox disease proceeds in a milder form, both in terms of general reactions (fever) and in relation to skin rashes (single number of vesicles that occur).
If more than 72-96 hours have passed since exposure to a person with chickenpox, would it make sense to get vaccinated today?
Yes. Although this vaccine will most likely be useless as an emergency vaccination, it can be given as a routine vaccination to prevent the disease in the future (if you are not infected now). The next contact with a person with chickenpox can happen at any time. Even if infection has occurred, the vaccination does not worsen the disease process, and theoretically it can even alleviate it.
Can I get vaccinated if I have been in contact with someone who has an infectious disease?
It is possible, it is not a withdrawal.
Guidelines MU 188.8.131.523-02 "Monitoring of post-vaccination complications and their prevention" (approved by the Chief State Sanitary Doctor of the Russian Federation on May 26, 2002)
“Clause 9.10. Vaccination of people who had contact with an infectious patient against the background of its possible incubation, it should not cause concern. In light of this, the withdrawal from vaccination of a child who could be in the incubation period of the infection cannot be considered justified. Taking into account the relevant WHO recommendation, Order of the Ministry of Health of Russia N 375 does not include contact with an infectious patient among the contraindications for vaccination.
If during the period after vaccination there was contact with some sick person and developed, for example, SARS, will this affect the effectiveness and safety of vaccination?
It won't affect. ARVI in the post-vaccination period does not affect the formation of immunity. Vaccination against chickenpox also does not affect the severity of SARS.
How long after a tuberculin test (Mantoux test) can the varicella vaccine be administered?
This can be done already on the day of checking the Mantoux reaction.
If the varicella vaccine is given first and then tuberculin tests are planned, how often should they be given?
After vaccination, the Mantoux reaction can be done no earlier than 1 month later.
Should a laboratory test be performed after the varicella vaccination to determine if protective antibodies have developed or not?
This is not necessary, as standard laboratory tests detect the presence of antibodies not to the vaccine component, but only to the wild varicella virus.