Although chickenpox is often considered a mild disease, it can cause even serious complications. Vaccinating is a gesture of responsibility that helps prevent the spread of the virus, reduce absences from school and work and create a safer environment
Chickenpox is a very contagious exanthematical disease, caused by the virus Chickenpox-zoster (VZV), belonging to the Herpesvirus family. He mainly affects preschool and school ages, between 5 and 10 years, but can also affect teenagers and adults.
The infection, after 10-21 days of incubation, manifests itself with fever, general malaise, loss of appetite and the subsequent appearance of the classic skin lesions: they begin as red spots, they become papules (reliefs), then vesicles full of light liquid and finally crusts that fall in one to two weeks.
The lesions appear on waves and can be present in various stages simultaneously, especially on the trunk, face and scalp, often accompanied by itching.
In the healthy small, chickenpox has, in most cases a benign course and resolves in 7-10 days, but not for this reason it must be underestimated. In fact, it can cause annoying complications, such as scars, bacterial superinfections of the skin, pneumonia or neurological problems, even if more rarely and in immunosuppressed subjects. In adults, the symptoms is more aggressive and the most common complication is pneumonia.
The virus is transmitted extremely ease by air (saliva, cough, sneezing) or by direct contact with the vesicles, making it one of the most popular pathogens in the school or family fields. The contagiousness starts from one/two days before the appearance of the eruption and can last until the appearance of the crusts.
After the chickenpox infection, almost all people develop lasting protection and hardly get sick again. However, the virus does not completely disappear: it remains silent, “asleep” in the body, hidden near the nerves of the back. In some people, especially after 50 years, this virus can “awaken” even after many years and cause herpes zoster, known as “Fire of Sant’Antonio”. It presents itself with grouped bubbles (similar to those of chickenpox) that appear on the chest or in other areas, often accompanied by pain and intense burning. In some cases, the pain can last even after the bubbles are healed (if it lasts more than a month it is called post-erpetic neuralgia).
Since 1995, a chickenpox vaccine has been available consisting of an attenuated virus. Since then, in the countries that have systematically adopted it, a drastic reduction of the most serious cases and complications have been observed.
In this article we will answer the most frequent questions of parents on the chickenpox vaccine. We will talk about the timing of vaccination, what are the possible complications, but above all we will focus on the benefits that this essential prevention tool has brought in terms of individual and collective health.
Is the chickenpox vaccine mandatory?
Yes, in Italy the vaccine against chickenpox is mandatory for new born since 2017. The obligation was introduced with law no. 119 of 31 July 2017, better known as the “Lorenzin law”, which has expanded the list of mandatory vaccinations for ten ten.
The chickenpox vaccine therefore falls among the vaccinations necessary for access to nursery schools and kindergartens. Parents who choose not to vaccinate children against chickenpox can incur administrative sanctions and unvaccinated children can be excluded from educational services.
This obligation responds to the objective of achieving high vaccination coverage, capable of protecting even the most vulnerable subjects (such as babies, immunosuppressed people or pregnancy women), thanks to group immunity.
The chickenpox vaccine can be postponed or not performed in the following cases:
- if the child has a health condition that contraindicates the vaccination (we will deepen later what is meant);
- If the child has already had chickenpox in the past.
When is the vaccine for chickenpox?
Vaccino for chickenpox and children
The chickenpox vaccine is administered in two doses, normally integrated into the child’s vaccination calendar.
It can be administered alone or, as the Ministry of Health and the Regions suggest, in a combined form (MPRV vaccine), or together with the vaccines against measles, parotitis and rubella, to reduce the number of injections.
- The first dose is expected between 13 and 15 months of age.
- The second dose is administered between 5 and 6 years.
This vaccination scheme is essential to ensure a robust and lasting immune response, and represents the most effective way to protect children, which are also the main virus transmission vehicle in the community.
Vaccino for chickenpox and adults
Even adults who have never had chickenpox and have never been vaccinated should take the vaccination into consideration. In adulthood, in fact, the disease can have a more severe course, with high fever, extensive rashes and more frequent complications (pneumonia, hepatitis, brain).
Vaccination is strongly recommended for the following subjects (always only if they have never had the disease):
- health workers;
- teachers and school staff;
- women of fertile age who want to plan a pregnancy;
- people who live with fragile subjects.
In adults, administration includes two doses at least four weeks later.
Chickenpox vaccine: the call
The second dose of the chickenpox vaccine has a key role in consolidating the response of the immune system. Although only one dose provides good protection (around 80-85%), the reference allows you to reach a cover of 95-98%.
Even in adult subjects who receive vaccination, the second dose is necessary to ensure effective protection.
Does the chickenpox vaccine give reactions or side effects?
Vaccination is safe and well tolerated. The most common symptoms of the chickenpox are:
- redness or swelling in the injection area;
- fever in the following days (sometimes associated with general malaise);
- The appearance of some bubbles similar to those of chickenpox, but in a very attenuated form (1-3% of vaccinated).
Many parents wonder when it appears and how long the fever caused by the chickenpox vaccine lasts. Unlike vaccines with inactivated viruses and bacteria, such as the hexavalent one, the symptoms can appear from 5 to 12 days after the injection and last one to two days.
Side effects of the most important chickenpox, such as feverish convulsions or serious allergic reactions, they are very rare. In children who have had feverish convulsions or who have a narrow relative who suffered from it, it is recommended to separate the administration of the vaccine against chickenpox from the MPR (morbillo-parotitis-rosolia), to further reduce the risks.
The safety of the vaccine is constantly controlled by the health authorities, both Italian and international. It should also be noted that the risk related to vaccination is decidedly lower than the risk of complications related to natural disease, especially in fragile subjects.
Effectiveness of the chickenpox vaccine
The effectiveness of the chickenpox vaccine is widely documented. With two doses, as mentioned, a protection of 95-98% is obtained against moderate or serious forms and 70-85% against mild forms (light forms without fever and with a limited number of skin lesions).
This has led to a marked improvement in the quality of life, a decrease in school days lost by children (and work for parents), as well as an important savings for the health system. In addition, vaccination offers effective protection against potential serious complications of chickenpox, which can arise in particularly delicate conditions, such as during pregnancy or age.
Vaccine for chickenpox and contraindications
There are some conditions that temporarily or permanently contraind the administration of the vaccine. In particular:
Permanent contraindications:
- Children or adults with very weak immune defenses for genetic diseases, severe HIV or other diseases.
- Those who have had a serious allergic reaction (anaphylaxis) at a previous dose of the vaccine or one of its components.
- Who received an organ transplant (kidney, liver, etc.).
Temporary contraindications (postponeable vaccine):
- Pregnant women.
- Those who have recently received antiviral drugs, immunosuppressants, radiotherapy or chemotherapy.
- Those who have received antibody -based products (immunoglobulins for ≤11 months) or has made a stem cell transplant for less than 2 years.
In case of high fever or acute infections in place, the administration should only be postponed. On the contrary, children with chronic pathologies, such as asthma, diabetes or heart disease, can and must be vaccinated, precisely because they are more vulnerable.
Any doubt can be clarified by the pediatrician or the family doctor, who will evaluate each case specifically.
Important note: in children who receive the vaccine, it is important to avoid aspirin or salicylate therapy in the six weeks following administration.
Vaccine for chickenpox in pregnancy
The chickenpox vaccine is not indicated in pregnancy, since it is a vaccine that contains the attenuated virus. The administration is contraindicated for the potential, albeit theoretical, risk of transmission of the virus to the fetus.
For this reason, it is advisable for women of fertile to verify, before a pregnancy, if they are already protected against chickenpox (through anamnesis or antibodies exam). If they are not immune, they can undergo the vaccine, which must be done at least a month before conception.
If a pregnant woman comes into contact with the virus and is not immune, it can receive post-exposure prophylaxis with specific immunoglobulins (VZIG) within 96 hours of contact. This treatment does not eliminate the risk of developing the disease, but can attenuate its intensity and reduce the danger to the fetus.
If a pregnant woman contracts chickenpox before the 28th week, the virus can, in rare cases, cause serious problems to the child. This condition is called congenital chickenpox syndrome and can lead to lesions on the skin, eye and nervous system problems.
Also contracting the chickenpox towards the end of pregnancy is risky: the newborn can be infected and develop a serious form of neonatal chickenpox.
For this reason, prevention through vaccination before pregnancy is an important and recommended measure.
The chickenpox vaccine can be administered during breastfeeding. Furthermore, in women who are not already immune to the disease, vaccination is recommended after childbirth, without any risk for the newborn. The chickenpox vaccine is safe and effective, protects both those who receive it both the community, especially the most fragile people. Although chickenpox is often considered a mild disease, it can cause even serious complications. Vaccinating is a gesture of responsibility that helps prevent the spread of the virus, reduce absences from school and work and create a safer environment. As mentioned, for any doubt or in -depth analysis, it is important to refer to your pediatrician or trusted doctor, who will be able to provide updated and personalized indications.
