Most Children Should Receive Chickenpox Vaccine
Jan. 10, 2000 (Baltimore) -- Although the vaccine against varicella, or
chickenpox, has been in use for some time, a large number of children aren't
immunized and should be, says a document released by the American Academy of
Pediatrics (AAP) updating their recommendations on the vaccine. The update
appears in the January issue of the journal Pediatrics.
"There are really three things that are important in this document,"
says Michael Gerber, MD, member of the committee on infectious diseases of the
AAP, in an interview with WebMD. "First is the recognition that although
the recommendation for universal use of the varicella vaccine was made in 1995,
a large number of eligible children remain unimmunized. Second, the Academy
[AAP] is now strongly encouraging pediatricians to support public health
officials in the development and implementation of varicella vaccine
requirements for daycare and school entry. And third is that the vaccine has
been shown to be safe in certain patients who are HIV positive and should be
administered to them."
Gerber says that some pediatricians and parents are resistant to the idea of
vaccinating all eligible children for chickenpox. "Although they are
decreasing in number, there are still some people who are not convinced the
vaccine is safe and effective," he says. "I think much of the
resistance among pediatricians is a reflection of the resistance on the part of
The update cites many studies showing the vaccine is safe and effective. One
new study has just been published in the December issue of the Pediatric
Infectious Disease Journal. This study looked at the vaccine effectiveness
in 11 day care centers serving between 1,100 and 1,500 children in North
Carolina. Comparing the number of chickenpox cases in vaccinated and
unvaccinated children, the vaccine effectiveness in this study was found to be
"Basically, what we saw is that as children are vaccinated, there is
less varicella disease, even among those who haven't been vaccinated,"
Christine Bland, RN, a research nurse at the Duke Vaccine Unit at Duke
University in Durham, N.C., and one of the authors of the study, tells WebMD.
"We're hoping that one day the vaccine will be made mandatory and we can
avoid any outbreaks of varicella. This is especially important as more children
who are immunocompromised attend day care and school. For these kids, the
infection can be quite deadly."
Gerber makes the point that the AAP is also recommending use of varicella
vaccine in children who have recently been exposed to chickenpox. "We now
have ample data to show that if the vaccine is given within three days of
[chickenpox] exposure it will prevent or modify disease. This is another way to
reduce or eliminate outbreaks of varicella in school and day care
"Children 12 months of age or older without documentation of varicella
immunization or infection who do not have a contraindication should receive a
dose of varicella vaccine immediately," the update states. "In
addition, special emphasis should be placed on immunization of susceptible
older children and adults, because the likelihood of severe infection increases
with increasing age."
- Although the American Academy of Pediatrics began recommending universal
administration of the chickenpox vaccine in 1995, a large number of eligible
children aren't immunized.
- All children over age 12 months should receive immunization, although both
pediatricians and parents can be resistant to the idea of vaccinating all
- Special emphasis should be placed on older patients, because the risk of
severe infection increases with age.