Preventing Chickenpox

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Chickenpox is highly contagious and can be spread by contact with an infected person, as well as through airborne respiratory secretions (droplets that are spewed into the air when someone sneezes or coughs). Taking steps to limit interaction with those who have chickenpox is helpful in terms of prevention, but the only (virtually) surefire way to avoid becoming infected with the varicella vaccine that causes the illness is by getting the chickenpox vaccine.

Avoidance

Since infected persons are contagious for one to two days before they develop a rash, it's possible to be exposed to someone who has chickenpox before they even know they're sick. In that case, there's obviously not much you can do about reducing your exposure—although, of course, it's always a good idea to follow healthy hygiene tactics for avoiding infection by any type of bug, such as washing your hands often.

When it comes to steering clear of the chickenpox virus when you know it's going around and you haven't had it yet or been vaccinated against it, there are further precautions you should take:

  • Stay away from people who are sick with chickenpox or shingles, if possible.
  • Wear disposable, non-latex gloves when touching objects or surfaces that may have been exposed to the virus.
  • On cruise ships, crew members with chickenpox often are instructed to wear long sleeves and long pants to decrease the number of blisters other people may be exposed to. Consider using this tactic when dressing a child who has chickenpox.
  • Consider setting up a cozy "sick room" for a family member who has chickenpox—a comfortable place where she can rest without feeling too isolated from everyone else.
  • Don't share cups, dishes, or eating utensils with a sick family member. Wash any such items she uses in the dishwasher or in hot, soapy water.
  • Disinfect non-porous surfaces (doorknobs, drawer handles, etc.) with a product approved by the Environmental Protection Agency for killing microbes such as viruses. Chlorine bleach (in a ratio of one-quarter cup per gallon of water) will do the trick, but non-bleach alternatives are safer. These include products that contain a bleach alternative such as oxygen bleach or hydrogen peroxide.
  • Don't kiss a person who has chickenpox: Direct contact with the blisters, especially any that haven't yet crusted over, is an invitation to infection.

Vaccination

Since the varicella vaccine was introduced in 1995, there's much less risk of getting sick with chickenpox. There are a few vaccines now available.

Varivax (varicella virus vaccine live) is the primary option used. The first dose is given to children at about 15 months of age at the same time as the separate measles, mumps, and rubella vaccine (MMR). A second dose of Varivax is given at 4 to 6 years of age, either with another dose of the MMR or as part of a combination vaccine known as ProQuad (MMRV).

Shingles (herpes zoster) can develop when the varicella virus is reactivated years after primary chickenpox. Vaccinations against this are important for protecting against shingles, but also chickenpox: Though someone cannot pass along shingles itself, someone with an active case can transmit the virus, which may cause chickenpox in individuals who have never had it or been vaccinated against it.

For adults, there are two immunizations to consider. The one most are familiar with, Zostavax (zoster vaccine live, or ZVL), is given as a single dose at age 60 or older. A newer option, Shingrix (recombinant zoster vaccine, or RZV) is considered more effective. It is made of engineered viral particles and is recommended for adults age 50 or older. It is typically given in a two-dose series, with the second shot being given two to six months after the first.

The vaccines made of the virus itself (Varivax, Zostavax) have live but attenuated versions of varicella. That means the virus has been made weaker than what you might get from someone who is infected. This less potent virus infects the cells and replicates in the bloodstream, which causes the immune system to develop antibodies to fight it off.

In most cases, this infection does not produce symptoms. If a vaccinated person gets chickenpox, the disease is mild 95 percent of the time. The length of time these antibodies stay effective is controversial, but it appears that vaccination does provide long-lasting immunity.

The side effects of the chickenpox vaccine are usually mild and include low-grade fever, mild discomfort at the vaccination site, and a limited rash (three to five lesions) at the vaccination site.

Who Should Get the Chickenpox Vaccine?

According to the Centers for Disease Control and Prevention, healthy people who have never had chickenpox or been previously vaccinated should get the vaccination according to the following recommendations: 

  • Children should get two doses of chickenpox vaccine—the first at 12 to 15 months and the second between 4 to 6 years. 
  • Teens (13 and older) and adults should get two doses, four to eight weeks apart. 

It isn't yet known how long the varicella vaccine provides protection, but current studies show immunity lasts at least 20 years.

Who Should Not Get the Chickenpox Vaccine

The chickenpox vaccine is very safe and effective, but there are a few groups of people it's not safe for. Here are some guidelines:

  • People who are ill, even moderately, when they're scheduled to get the shot should usually wait until they recover.
  • Pregnant women should wait to get the chickenpox vaccine until after their babies are born. Similarly, it's advisable to wait at least a month after getting the shot before trying to conceive.
  • Anyone who has HIV/AIDS or another disease that affects the immune system; has been taking medication that affects the immune system, such as steroids, for two weeks or longer; has any kind of cancer or is being treated for cancer with chemotherapy or radiation should not get the varicella vaccine without first checking with the doctor who's treating them.
  • People who've recently had a transfusion or were given other blood products should speak to their doctor about the vaccine before getting it.
  • People who have ever had a life-threatening allergic reaction to gelatin, the antibiotic neomycin, or a previous dose of chickenpox vaccine should not be vaccinated or should consult with their doctor first. 

    Some people for whom the vaccine would be perfectly safe choose not to get the shot for themselves, figuring that if they go ahead and get sick they will only have to endure the discomfort once and will be immune to infection going forward since their bodies will have created natural immunity. Likewise, in the past, there have been parents who've chosen to expose their kids to the varicella virus at so-called "chickenpox parties."

    But purposeful exposure to varicella isn't good for anyone. Once the varicella virus is allowed into the body, it doesn't leave, even after any symptoms it causes are long gone. Instead, the virus takes up residence in the nervous system, where it can lie dormant for decades and then suddenly become active again in the form of a disease called shingles.

    Shingles affects 10 percent of people over age 60, according to the CDC. It causes a nasty rash that is painful, itchy, and unsightly and that can leave permanent scarring. Other symptoms of shingles can include a headache, sensitivity to light, and general malaise.

    This experience is highly unpleasant. If you've never had chickenpox or have young children, you easily can prevent it and shingles with just a couple needle pricks.

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