Adults Skip Varicella Immunization at Their Own Peril – Virus Doesn’t Care How Old You Are

February 27, 2024

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Since the mid-1990s, routine chickenpox vaccination has drastically cut infection rates where implemented. But immunity gaps still leave some groups vulnerable. Understanding current best practices for varicella immunization is crucial.

Who Needs the Varicella Vaccine?

The CDC recommends the injectable chickenpox vaccine for:

  • All children (2 doses)
  • Teens/adults with no history of disease or immunization (2 doses)
  • Non-immune people exposed to chickenpox

Overall, anyone over 12 months old without laboratory evidence of varicella immunity should complete the 2-dose schedule. This includes:

  • Those never vaccinated
  • People uncertain if they had chickenpox
  • Adults in settings with exposure risk (e.g. healthcare)

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What Is the Chickenpox Vaccine Schedule?

Children receive the initial varicella vaccine dose between 12-15 months old, with the second dose at 4-6 years of age. This timing ensures robust protective antibodies before kindergarten entry.

For older children, teens and adults, two doses should be given 4-8 weeks apart if never vaccinated previously. This same schedule applies for healthcare personnel, pregnant women post-delivery, immigrants, and other high exposure risk groups lacking confirmed prior chickenpox history.

Is the Vaccine Effective in Adults?

Yes. The varicella vaccine shows 70-90% effectiveness against primary VZV infection resulting in chickenpox disease in adults when properly administered. As immunity from either natural infection or vaccination slowly wanes over time, receiving the vaccine in adulthood helps close population-level immunity gaps.

Adult vaccination generates antibody protection and immunologic memory more quickly than childhood infection. It’s broadly recommended since adults tend to suffer increased chickenpox severity and complications versus children.

How Does Natural vs Vaccine Immunity Compare?

Those who recover after chickenpox illness acquire natural immunity, typically protecting against reinfection. But over time, protection can decrease, raising shingles reactivation risks in older groups.

Conversely, the varicella vaccine encodes immune memory similar to the wild-type virus but without causing acute illness first. It offers ~20 year immunity and is associated with over 90% effectiveness against moderate/severe breakthrough disease post-vaccination if a rare case even occurs.

Should Pregnant Women Get Vaccinated?

Pregnant women are advised to get the varicella vaccine upon completion of pregnancy if never infected previously. Contracting primary VZV infection in pregnancy can risk congenital varicella syndrome if before 20 weeks gestation or even neonatal chickenpox if close to delivery.

By closing maternal immunity gaps to prevent acquisition, vaccination protects a woman and her vulnerable baby. Dose timing for pregnant groups is:

  • 1st Dose: Post-pregnancy before hospital discharge
  • 2nd Dose: Minimum of 4 weeks later

This preserves optimal safety while rapidly ensuring robust antibody transfer to newborns. For women vaccinated pre-conception, subsequent pregnancies carry lower infection risks.

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Frequently Asked Questions

Is the vaccine safe in older adults?

Yes. The chickenpox shot demonstrates an excellent safety profile in all groups studied, including seniors. Side effects like injection site reactions or rash are usually mild. Severe vaccine complications are very rare (about 1 in 1 million doses)…

Can I get the shot if I had chickenpox?

Likely not necessary…But if you’re uncertain of true prior varicella infection history, getting a blood test to check immunity first or else opting for vaccination is reasonable depending on occupational exposure risks…

How many doses are needed over a lifetime?

For most people, receiving two age-appropriate chickenpox vaccine doses confers durable protection without need for routine adult boosting at this time…But immunity monitoring and possible additional booster policy could adjust in older groups per future data…

Are vaccine exemptions allowed?

In some areas, medical, religious or personal belief exemptions to school entry chickenpox immunization rules are permitted. But health authorities strongly recommend universal vaccination to protect public health unless contraindicated…

Can vaccinated kids still spread chickenpox?

Breakthrough cases post-vaccination are rare…But if a mild infection occurs, transmission risk is significantly cut versus unimmunized cases in terms of contagious period and viral load…Still, isolating anyone with symptoms remains wise…

Key Takeaways

In closing, major varicella immunization points include:

  • Safe, effective chickenpox vaccines available since 1995
  • Universal vaccination protects on personal + public health scale
  • Two-dose schedule correctly spaced gives optimal protection
  • Adults with uncertain history benefit from catch-up vaccination
  • Vaccine immunity compares favorably to natural infection

Overall, embracing routine chickenpox vaccination for vulnerable groups, including older adults, limits virus circulation in communities while preventing often serious illness in those at highest risk. By recognizing the value of properly administered varicella immunization across age groups, coverage gaps get closed and population health improves.

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