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Yearly Vaccination for Chickenpox?
Q: I've been told that you have to be inoculated for chickenpox each and every year once you start the innoculations. Is this correct? So, theoretically, if this is true, if you forget and miss an inoculation you could still get chickenpox or worse if you're an adult. I'll be anxiously awaiting your answer.
A: The current recommendation by the Advisory Committee on Immunization Practice (ACIP) in conjunction with the American Academy of Pediatrics (AAP) and the American Academy of Family physicians (AAFP) is routine immunization of all children12-18 months of age and all susceptible children 19 months to 12 years of age. Immunization is also recommended for susceptible individuals 13 years of age and older with specific emphasis on teachers of young children, international travelers, health-care workers, college students, child-care workers, residents and staff in institutional settings, military personnel, and other susceptible persons at high risk for exposure. The vaccination may not result in protection of all healthy susceptible children, adolescents, and adults, but in general it is very effective.
It is not true that you need annual vaccinations for chickenpox "each and every year." It is true that over the age of 12, that you do need two doses of vaccine to develop adequate protection, but at this point there are no specific recommendations for further vaccine boosters. Other vaccines have initially been recommended as single injections, but over time and with ongoing surveillance, boosters have been recommended.
There is a controversy on whether to immunize everyone or would it be better to get the disease naturally and be immune for life. In newborn infants, adults, pregnant women, and immunocompromised patients, chickenpox does pose special risks. So the theoretical risk that over time adults will not have adequate protection from being immunized in childhood raises the concern of more cases of chickenpox in adulthood.
Vaccines have been very effective and have contributed to a significant decline of many infectious diseases of childhood. Whether this will happen with the administration of varicella vaccine is to be determined with the current long-term studies being conducted in children and adults.
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Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.