Why Do Some People Get Chickenpox Twice?

Children typically build up a lifelong immunity to chickenpox (varicella) after getting an infection and don't get it again. But parents may still wonder whether their child might get this infection twice, and whether vaccination is recommended after a child has a case of varicella.

Getting Chickenpox Twice

There are some situations in which a child might get chickenpox more than once, including:

  • Getting their first case of chickenpox when they were very young, especially if they were younger than 6 months old
  • Having a very mild or subclinical infection the first time
  • Developing a problem with their immune system

Vaccination After Chickenpox Infection

Although most children who get chickenpox are considered naturally immune and don't need to get a chickenpox vaccine, you might consider getting them vaccinated if they were very young or had a very mild case of chickenpox. That should hopefully keep most of these kids from getting chickenpox twice.

And with so many kids having been vaccinated, there are also fewer folks around to expose an immunocompromised child or adult to chicken pox. Those factors make it even less likely for a child to get a repeat infection.

Most People Don't Get It Twice

So if it is so uncommon, why might a child still get chickenpox twice? One common reason for a child to have a 'second' attack of chickenpox is simply because the first case, or maybe the second case, was really something else that was misdiagnosed as chickenpox.

Although a full-blown case of chickenpox is hard to miss, other viral infections and even insect bites can be misdiagnosed as mild cases of chickenpox, especially by non-medical personnel, including parents and day care workers.

Testing for chickenpox is rarely required, but there are tests that can confirm if a child has chickenpox. These can be helpful in mild cases or when a child has a suspected second case of chickenpox.

Tests for chicken pox can include:

  • PCR or DFA of cellular matter from an unroofed vesicle
  • Viral culture of fluid from chicken pox lesion
  • IgG and IgM antibody levels

Fortunately, with the rise in the use of chickenpox vaccine, the incidence of first and second cases of chickenpox is much less common these days.

Still, according to the CDC, "Immunity following varicella infection is considered to be long-lasting and second cases of varicella are thought to be rare. However, second cases may occur more commonly among immunocompetent persons than previously considered."

Chicken Pox Doctor Discussion Guide

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Article Sources

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  • Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases (Eighth Edition)
  • Manual for the Surveillance of Vaccine-Preventable Diseases
  • Vaccines (Sixth Edition) 2013