Medical Conditions

Chickenpox Vaccine, The

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(Please see the related Vaccine Information Statement, The Chickenpox Vaccine: What You Need to Know)

Chickenpox can be itchy and uncomfortable for your child. It was one of the most common childhood illnesses before the chickenpox vaccine was recommended routinely for infants. Anyone who hasn't received the vaccine can get chickenpox if exposed, but it occurs most often in children 9 to 11 years of age. It's also called varicella.

The most obvious sign of chickenpox is a very itchy rash with tiny bumps, blisters, and scabbed-over areas all at the same time. Often symptoms are mild. In some cases, symptoms can be severe, especially for newborns, teens, and adults. This is why the chickenpox vaccine is important. It's one way you can protect your child from getting chickenpox. Read more to learn about chickenpox and the chickenpox vaccine.

What are the symptoms of chickenpox?

First, a rash of tiny blisters develops on your child's scalp and body. Over 3 to 4 days this rash spreads to the face, arms, and legs. Your child may have between 250 to 500 small, itchy blisters or just a few. After 2 to 4 days, the first blisters usually dry up. Then they scab over and finally heal. At any one time, children will have part of the rash that is tiny bumps, part that is tiny blisters, and part that is scabbed over and dried up. Tiny sores and scars may develop. If your child scratches the blisters, they can become infected.

Your child also may have a fever and other symptoms including

  • Coughing

  • Fussiness

  • Loss of appetite

  • Headaches

How is chickenpox spread?

Chickenpox is very contagious. It's only spread from humans. After your child is exposed to the virus that causes chickenpox, it will take 10 to 21 days before symptoms appear. Your child is contagious 1 to 2 days before the rash starts and for up to 5 days after the rash appears. Your child will have to stay home from child care or school until she is no longer contagious.

The chickenpox virus may be spread

  • Through the air when an infected person coughs or sneezes

  • By direct contact with the fluid from broken blisters of an infected person

  • By direct contact with sores from a person with shingles

  • Children and adults have a very high risk of getting chickenpox if they have never had the disease or received chickenpox vaccine and someone at home or school has chickenpox.

How is chickenpox treated?

Acyclovir can help make the symptoms of chickenpox less severe if taken within 24 hours after the start of the rash. Most children don't need this medicine, though. Your pediatrician may prescribe it or a related medicine if your child has eczema or asthma, has a weakened immune system, or is a teen.

The following are things you can do at home:

  • Remind your child not to scratch. If your child scratches the blisters before they are able to heal, they can become infected, can turn into small sores, and may leave scars.

  • Trim your child's nails. You can help prevent other infections by keeping your child's fingernails trimmed.

  • Relieve the itch. An oatmeal bath may help ease the itch. Oatmeal baths are available without a prescription.

  • Reduce a fever. Never give aspirin or other salicylates (medicines used to reduce pain or fever) to your child unless your pediatrician says it's OK. Aspirin has been linked to Reye syndrome, a serious illness that involves the liver and brain, especially when given to children with chickenpox or the flu (influenza). Acetaminophen or ibuprofen may help reduce your child's fever. Call your pediatrician if your child's fever lasts longer than 4 days or rises above 102°F or 39°C after the third day of having chickenpox, or if your child becomes dehydrated. Let your pediatrician know if the rash gets very red, warm, or tender. Your child may have an infection that needs other treatment.

Can chickenpox cause other problems?

Most healthy children who get chickenpox won't have any problems. Before the vaccine was available, each year in the United States about 10,500 to 13,500 people were hospitalized for chickenpox and about 100 to 150 people died from the disease.

The most common problem from chickenpox is a bacterial infection of the skin. Two other problems are pneumonia and encephalitis (an inflammation of the brain). The following groups are at higher risk of developing these problems:

  • People who have weak immune systems and get sick easily

  • Infants younger than 1 year

  • Teens and adults

  • Newborns whose mothers had chickenpox around the time of delivery

  • Premature infants whose mothers have not had chickenpox

  • Children with eczema and other skin conditions

  • Children taking salicylates

When adults get chickenpox, the disease is usually more severe. For example,

  • Adults often develop pneumonia.

  • Adults are almost 10 times more likely to be hospitalized than children younger than 14 years.

  • Adults are more than 20 times more likely to die from chickenpox.

  • If a pregnant woman gets chickenpox, her unborn baby may have problems.

When should my child get the chickenpox vaccine?

The American Academy of Pediatrics recommends 2 doses of the chickenpox vaccine for all healthy children who have not had chickenpox. The first dose should be given between 12 to 15 months of age. The second dose should be given between 4 to 6 years of age but may be given earlier if given at least 28 days after the first dose.

During your child's well-child visits, your pediatrician will let you know if your child needs the chickenpox vaccine. Ask your pediatrician about when your child should get the vaccine if your child hasn't received it by 15 months of age. People 13 years of age and older who have never received the chickenpox vaccine or had the chickenpox also should get 2 doses at least 28 days apart.

The chickenpox vaccine may be given to your child at the same time as other vaccines.

Why should I vaccinate my child?

Most children who get the chickenpox vaccine don't get chickenpox. If a vaccinated child does get it, the symptoms are generally much milder (for example, fewer sores and a low fever or no fever). In fact, the disease may be so mild that the sores look like insect bites. Also, a vaccinated child may get well faster.

Aside from the health benefits, vaccinating your child could save you time and money. In general, a child with chickenpox may need to miss up to 9 days of school; parents may need to miss work to care for their child.

Is the chickenpox vaccine safe?

Yes. Many studies show the chickenpox vaccine is safe and effective. Because the chickenpox vaccine was licensed in 1995, millions of doses of vaccine have been given to children in the United States.

In general, side effects from the chickenpox vaccine are mild and include

  • Redness, soreness, or swelling where the shot was given

  • Tiredness

  • Fussiness

  • Fever

  • Nausea

A few children develop a rash at the spot where the shot was given or on other parts of the body. This can occur up to 1 month after the shot and can last for several days.

Who should NOT get the vaccine?

Although the chickenpox vaccine is safe for healthy children, it's not safe for the following people:

  • Children with weakened immune systems

  • Children with severe allergies to gelatin or the antibiotic neomycin

  • Pregnant women

If you are concerned, ask your pediatrician if the chickenpox vaccine is safe for your child.

What is shingles?

Once someone has had chickenpox, the virus stays in the body of the infected person forever. About 10% to 20% of all people who have had chickenpox develop shingles. Clusters of blister-like sores develop and last for 2 to 3 weeks. People with shingles usually feel numbness and itching or severe pain. Anyone can get shingles, but it usually occurs in adults older than 50 years. A new vaccine to prevent shingles has just become available for people 60 years of age or older.

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