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20 July, 2008

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Chickenpox vaccine

Chickenpox (varicella) is a highly infectious disease that usually causes an itchy red rash with blisters. It is one of the most common childhood diseases and can affect adults as well. In most cases, people recover fully from chickenpox. In rare cases, there can be complications.

Immunisation program
The vaccine is available free-of-charge under the National Immunisation Schedule. The age group for eligible children varies between States and Territories. In Victoria, it is available to:

All infants at 18 months of age
Year 7 secondary school students as a ‘catch-up’ immunisation if they have not had chickenpox or received the vaccine. This program is being conducted together with the Year 7 school-based hepatitis B vaccination catch-up program.

Other people may be charged for the chickenpox vaccine. Your immunisation provider can provide more information on vaccination against chickenpox.

How the vaccine works
The chickenpox vaccine is used in children aged from 12 months or older, adolescents and adults. It contains a weakened form of the chickenpox (varicella-zoster) virus and works by causing the body to reproduce its own antibodies to protect against the disease.

The risks of chickenpox
While most people recover fully from a dose of chickenpox, it can cause complications in children with lowered immunity and in some adults.

Chickenpox can be expensive and inconvenient. In the average household, a child with chickenpox may miss up to two weeks of school. Most children recover from chickenpox with no ongoing problems. However, chickenpox can cause serious complications such as skin infections, pneumonia and inflammation of the brain. In some cases, the illness is fatal.

Chickenpox infection in the first half of pregnancy can cause malformations, skin scarring and other problems in the baby.

A person who has had chickenpox develops immunity and usually does not contract it again. However, the virus remains within the body after the initial infection and sometimes causes a condition known as ‘shingles’ (herpes zoster) later in life. This condition causes a localised rash, which can result in severe and long-lasting pain.

Benefits of the vaccine
Vaccination can prevent serious medical problems and reduce the costs of chickenpox.
For children who have not had chickenpox, the vaccine can help protect them against shingles in later life as well as the actual chickenpox illness.

Vaccinated children who do get chickenpox generally have a much milder form of the disease. They have fewer skin lesions, a lower fever and recover more quickly.

People who benefit most from vaccination include:

Infants and children
Adults not immune to chickenpox, especially parents with young children and people in ‘at-risk’ occupations such as teachers, childcare workers and health care workers
Non-immune women at least one month prior to pregnancy
Non-immune adults and young children who live with people who have lowered immunity and have no history of chickenpox.

Children and adults who are known to have had chickenpox are considered to be immune.

Some people should not receive the vaccine
The chickenpox vaccine should not be given if:

You or your child has an allergic reaction to the vaccine or any ingredients contained in the vaccine (ask your doctor about the ingredients). Signs of an allergic reaction may include an itchy rash, shortness of breath and swelling of the face and tongue.
You are, or think you may be, pregnant.
You intend to become pregnant within one month of vaccination.
You or your child has lowered immunity due to immune deficiency, abnormal blood conditions or disorders, cancer, HIV or certain medications.
You or your child has a severe infection with a high temperature.
You have had another live virus-containing vaccine within the last month, such as a vaccine for measles, mumps or rubella.

Precautions before vaccination
Before having the vaccine, tell your doctor or nurse if:

You or your child has allergies to any other medicines or substances
You or your child has received another vaccine within the last month
You or your child has received a blood or plasma transfusion or immunoglobulins within the last three to nine months
You or your child is taking any prescription or over-the-counter medicines.

How the vaccine is administered
A doctor or nurse will inject the vaccine under the skin of the upper arm or thigh. It should never be given intravenously. Children are given the vaccine as a single dose. Adults and adolescents aged 14 years and older are generally given two doses, one to two months apart.

Precautions during or after a course of the vaccine
Following or during a course of vaccination, make sure you tell your doctor if:

You become pregnant
You or your child is to have another vaccine within one month of the chickenpox vaccination
Immunoglobulin-containing products will need to be administered within three weeks of the chickenpox vaccination
You or your child develops a rash within four weeks after vaccination – avoid contact with people who have low immunity while the rash lasts
You or your child is to have a skin test for tuberculosis within 4–6 weeks after vaccination.

Possible side effects of the vaccine
All vaccines and medicines can have side effects; however, these are usually not serious. Side effects from the chickenpox vaccine may include:

Redness, swelling or soreness at the injection site
High fever (over 39�C)
Mild chickenpox-like rash – this may develop five to 26 days after the immunisation.

Although uncommon, some people may contract a very mild dose of chickenpox a year after receiving the vaccine, as it is not fully effective in every person.

If you are concerned about your reaction or your child’s reaction, see your doctor immediately.

Allergic reaction
There is a very small risk of a serious allergic reaction to any vaccine. It is important to stay at the clinic where the immunisation was given for 15 minutes after the vaccination.

Where to get help

Your doctor
Nurse on Call Tel. 1300 606 024 – for expert health information and advice (24 hours, 7 days)
Your local government immunisation service provider

Things to remember

Chickenpox is a highly infectious disease that sometimes causes complications.
The chickenpox vaccine is of greatest benefit to children over 12 months and people who live with someone with lowered immunity.
Serious side effects or allergic reactions to the vaccine should be attended to immediately by your doctor or at the nearest hospital.