CHICKENPOX

STUDENT HEALTH SERVICES
9001 Stockdale Highway
Bakersfield, California 93311
(661) 654-2394 Fax: (661) 654-3301

CHICKENPOX and VARICELLA VACCINE

Chickenpox is an acute, generalized, viral disease of sudden onset with slight fever, mild constitutional symptoms and skin eruptions. Rarely fatal, a primary viral pneumonia is the commonest cause of death in adults; septic complications and encephalitis are the common cause of death in children. Neonates who develop varicella between day 5 and 10 or those whose mothers contact the disease prior to or within 5 days after delivery are at increased risk of developing severe generalized chickenpox with a 30% mortality rate. Herpes zoster is a local manifestation of recurrent, recrudescent or reactivation infection with the same virus.

Vaccination is now available for the varicella virus. Varivax is a live, attenuated vaccine approved by the FDA for vaccination against chickenpox. The vaccine safely and effectively reduces the incidence and severity of natural varicella. It has been useful following known exposure, and has some efficacy in adults.

An unanswered question is whether the vaccine virus becomes latent, resulting in later development of herpes zoster (shingles).

Candidates for vaccination:

Children 12 months or older who have not had chickenpox

Persons at risk for developing chickenpox due to recent exposure may benefit from vaccination to prevent or reduce symptoms of the disease

Persons at risk working in a school, pre-school or health care environment which may put susceptible children, pregnant women or immunocompromized patients at risk

Women anticipating future pregnancy

Precautions:

Hypersensitive to any of the components, including previous anaphylactic reactions to neomycin

Febrile illness

Pregnancy and those women planning to become pregnant within the next three months

Nursing women

Blood dyscrasias or other malignant neoplasms

Persons on immunosuppressive therapy

Persons with primary or acquired immunodeficiency

Reactions:

Pain at injection site

Redness and swelling at injection site

Chickenpox-like rash, generalized or localized near the injection

site, pruritis

Hematoma, induration or stiffness

Fever

Administration and Dosage:

The dosage for adults receiving the vaccine is 2 injections in the upper arm given 4 to 8 weeks apart.

Varicella and MMR have been successfully given at the same time at different injection sites or combined. Vaccination should be deferred for at least 5 months following blood or plasma transfusions, or administration of IG or VZIG. After vaccination any IG should not be given for 2 months unless its usefulness outweighs the benefits.

Duration of Immunity:

In healthy adolescents and adults antibody levels were present at least 1 year in 97.2% of individuals who received 2 injections 4 to 8 weeks apart. The duration of protection is unknown at present and the need for booster doses is not defined.

Post vaccination instructions:

Avoid pregnancy for at least 3 months

Avoid salicylates for 6 weeks after vaccination as Reye's syndrome has been reported following salicylate use during natural varicella infections.

Individuals vaccinated with varicella may potentially be capable of transmitting the vaccine to close contacts. Therefore, vaccine recipients should avoid close association with susceptible high risk individuals (newborns, pregnant women, immunocompromized persons).

Review possible reactions

Report any adverse effects to their health care provider.

Resources:

Control of Communicable Diseases in California
Drug Facts and Comparisons
Modern Medicine, Volume 63, May 1995
Kern County Health Department

CSUB STUDENT HEALTH SERVICES (661) 654-2394 Updated 2/06 ck