Current pediatric health guidelines call for vaccinating children against chickenpox at age 12 months and older. In addition, it is recommended that appropriate susceptible older children, adolescents, and adults be vaccinated. Chickenpox vaccination is recommended because it can help prevent serious cases of the disease. A severe case of chickenpox may be associated with complications such as bacterial superinfection, pneumonia, encephalitis (swelling of the brain), hospitalization and, in rare cases, death.
Sometimes, children vaccinated against chickenpox may develop a mild case of chickenpox following exposure to "natural" or "wild-type" disease. This is known as "breakthrough" disease; individuals developing breakthrough disease generally experience fewer than 50 lesions. Some wonder if breakthrough disease indicates the chickenpox vaccine is not effective. Below are common questions about breakthrough disease.
Q. I've heard of children getting chickenpox after being vaccinated. What is this called?
A. When an individual develops chickenpox after receiving the vaccine, it is called breakthrough disease. Breakthrough disease is "wild-type" or "natural" chickenpox that develops in a child six weeks or more after having been vaccinated following close contact with a person with chickenpox.
Q. Can I tell if my child will get breakthrough disease?
A. Doctors can't predict which children will be among the few who might develop breakthrough disease after being vaccinated and then exposed to wild-type virus in the community. However, in addition to experiencing milder disease, most children who develop chickenpox after being vaccinated are also at a lower risk for serious complications that can develop with natural chickenpox disease.
It should be noted, however, that vaccination may not result in protection of all healthy susceptible children, adolescents, and adults. Moreover, the chickenpox vaccine is not for everyone. For example, it is contraindicated in persons with a history of hypersensitivity to any component of the vaccine, including gelatin.
Q. If my child does develop breakthrough disease, should I worry?
A. Breakthrough disease is generally mild. The few children who develop breakthrough will typically have mild symptoms with a few lesions (usually less than 50).
Q. If vaccinated children can get breakthrough, doesn't that mean natural chickenpox disease provides better immunity?
A. Not necessarily. Vaccination may be the best way to protect against severe cases of the disease; severe cases of chickenpox may be associated with life-threatening complications. Parents should talk to their healthcare provider about whether vaccination is right for their child.
Q. Should I wait to get my child vaccinated?
A: There is no need to wait to get your child vaccinated against chickenpox. Children may receive the chickenpox vaccine at 12 months or older. Postponing your child's vaccination may increase the likelihood that he or she could be exposed to the virus and develop the disease, with potentially serious consequences.
Adverse reactions that have been reported with the use of the chickenpox vaccine include fever, injection site complaints and rash (injection site and generalized). For more information about the side effects associated with the vaccine, talk to your healthcare provider.
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