Silverbirch Medical Practice, Bangor, County Down, Northern Ireland

Chickenpox vaccine | Chickenpox vaccination 

Chickepox vaccine £70 per dose | £140 per course

Chicken Pox

Chickenpox (varicella) is an acute, highly infectious disease caused by the varicella zoster (VZ) virus.

Transmission

Varicella zoster virus is transmitted directly by personal contact or by droplet spread through coughing and sneezing.  It can also be transmitted through contact with infected clothing or bedding. The time between being infected with the virus and developing signs of infection (the incubation period) is between one and three weeks.

Because chickenpox is highly infectious the secondary infection rate from household contact with a case of chickenpox can be as high as 90%. The infection is most common in children below the age of 10, in whom it usually causes mild disease.

The disease can be more serious in adults, particularly pregnant women and those who smoke, as they are at greater risk of severe varicella pneumonia.

Chickenpox is seasonal and usually reaches a peak from March to May, although in recent years seasonality has been less marked. Since chickenpox is so common in childhood, 90% of adults raised in the UK are immune.

It is possible to develop Chickenpox from contact with someone who has shingles. However, you cannot contract shingles directly from someone who is infected with Chickenpox.

The virus is most infectious 1-2 days before the rash occurs and for around 5 days after (or until the rash crusts over). This may be prolonged in immunosuppressed patients.

Symptoms

The illness usually starts with one or two days of fever and feeling unwell although this may not occur, particularly in young children.   Small blisters called vesicles begin to appear on the face and scalp, spreading to the chest, back and abdomen and eventually to the arms and legs. After three or four days, the vesicles dry with a granular scab and are usually followed by further crops. Vesicles may be so few as to be missed or so numerous that they become joined together to form larger patches, covering most of the body. The chickenpox rash can be intensely itchy and distressing, affecting sleep, school and work and can cause scarring of the skin.

Complications

The majority of children recover without any complications but very young babies, adults, pregnant women and those who are immunocompromised may have more serious complications.

Complications include:

  • Lung involvement (varicella pneumonia or secondary bacterial pneumonia)
  • Central nervous system involvement including cerebellar ataxia (poor co-ordination of limb movements, staggering walk) encephalitis (inflammation of the brain tissue)
  • Secondary bacterial infections of the skin, soft tissues or bone
  • Bleeding complications
  • In pregnancy
    • considerable maternal morbidity
    • congenital varicella syndrome in 10% if infected in first 20 weeks of gestation
  • Less common complications include
    • arthritis, inflammation of the kidneys, and inflammation of the heart

The varicella (chickenpox) vaccine

The Chickenpox vaccine has been used routinely in the childhood immunisation programme in the United States since 1995.  Many other countries including Germany and Australia also routinely provide the vaccination in their immunisation schedules.

The vaccine is live, containing virus which has been attenuated (weakened). The two-dose vaccination schedule provides about 98% protection in children and about 75% protection in adolescents and adults. In both age groups, most of the breakthrough infections are milder and vaccinated individuals who contract chickenpox have fewer blisters and less systemic upset than unvaccinated individuals.

Dosage and schedules

Children from one year of age or older and adults should receive two doses of varicella vaccine, four to eight weeks apart (and certainly not less than four weeks apart).

The vaccination can be administered by either intramuscular (Varivax) or subcutaneous injection (Varivax and Varilix).

Varicella vaccine can be given at the same time as other live vaccines such as MMR or if not given at the same time should be given at least 4 weeks apart.

Inclusions

The vaccine can be given to people over 12 months of age:

to prevent development of Chickenpox infection in those who have never had it

to protect occupational groups, such as those working with children and health care workers who have never had Chickenpox infection

to prevent healthy susceptible contacts of immunocompromised patients from transmitting natural infection to them. For example, siblings of a leukaemic child, or a child whose parent is undergoing chemotherapy.

Post-exposure prophylaxis (Varivax only)

Varivax is licensed for post-exposure prophylaxis.  Vaccination within 3 days of exposure may help prevent chickenpox or reduce the severity of disease, resulting in fewer skin lesions and shorter duration of illness. In addition, there is limited information that being vaccinated up to 5 days after exposure may reduce disease severity.

Contraindications

The vaccine should not be given to:

  • Anyone with a weakened or suppressed immune system such as patients with HIV, AIDS, cancers, leukaemia, or lymphoma or patients taking immune suppressing medicines such as chemotherapy, methotrexate, azathioprine, ciclosporin or high doses of steroids.
  • Pregnant women. Pregnancy should be avoided for one month following the last dose of varicella vaccine (see below)
  • Anyone who is allergic to any varicella vaccine, to any of the components of the vaccine (including gelatin, neomycin or any of the other ingredients listed at the bottom of this page
  • Anyone with active untreated tuberculosis.
  • Anyone with a temperature higher than 38.5°C

Use of salicylates

Aspirin and systemic salicylates should not be given to children under 16 years of age, except under medical supervision. Vaccination with varicella vaccine is not contraindicated in individuals aged 16 years or over who need to take aspirin.

Adverse reactions

Chicken pox vaccines are well tolerated. Extensive clinical and post-marketing safety surveillance data from the US shows the most commonly reported reactions are at the injection site (pain, redness and rash). Generalised symptoms, such as fever and rash, can also occur but less frequently.

Up to 10% of adults and 5% of children develop a vaccine-associated rash, either localised at the injection site or generalised, within one month of immunisation.

The vaccine virus strain can establish latent infection and reactivate to cause herpes zoster (shingles), but the risk is substantially lower than with wild-type chickenpox infection.

Transmission of vaccine virus from immunocompetent vaccinees to susceptible close contacts has occasionally been documented but the risk is very low. Transmission in the absence of a post-vaccination rash has not been documented.

Very common reactions (reported by more than 1 out of 10 people) were:

  • fever
  • injection site redness of the skin, pain/sensitivity to touch/soreness, and swelling

Common reactions (reported by less than 1 out of 10 but more than 1 out of 100 people) were:

  • upper respiratory tract infection (nose, throat, airway)
  • irritability
  • rash, measles-/rubella-/varicella-like rash
  • injection site rash, itching at the injection site

Ingredients

VARIVAX

  • Live attenuated varicella virus (Oka/Merck strain) (produced in MRC-5 human diploid cells).
  • Sucrose
  • Hydrolysed gelatin
  • Urea
  • Sodium chloride
  • Monosodium L-glutamate,
  • Anhydrous disodium phosphate,
  • Potassium dihydrogen phosphate
  • Potassium chloride
  • Trace quantities of the antibiotic neomycin
  • Water

VARILIX

  • Live attenuated Varicella zoster (Oka strain) virus prepared in MRC5 human diploid cells.
  • Amino acids
  • Lactose
  • Mannitol
  • Sorbitol

For more information see:

If you would like to arrange a chickenpox vaccination for yourself or your child/children please Contact Us to book a consultation.

Cost

Chicken pox vaccine £70 per dose.  Two doses required.

Chickenpox vaccine NI | Chickenpox vaccine Bangor | Private Chickenpox vaccine NI | Private chickenpox vaccine Bangor

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