Brady Collins
Chickenpox, or varicella, is a highly contagious disease that can cause serious complications, especially in vulnerable groups such as infants, pregnant women, and people with weakened immune systems. To prevent infection and severe illness, the CDC recommends two doses of the varicella vaccine for children, adolescents, and adults who have never had chickenpox or received the vaccine. While the vaccine is generally safe and effective, certain groups should not receive it or should consult a healthcare provider first, including those with HIV/AIDS, cancer, or other immune-compromising conditions, as well as pregnant women. There are two types of varicella vaccines available in the United States: the single-antigen varicella vaccine and the measles, mumps, rubella, and varicella (MMRV) vaccine. This article will specifically discuss whether there are any varicella vaccines that do not include WI-38.
| Characteristics | Values |
|---|---|
| Number of doses | Two doses are recommended for children, adolescents, and adults who do not have immunity. |
| Effectiveness | 70% to 90% effective after one dose and more than 95% effective after two doses. |
| Side effects | Minor side effects may include pain at the site of injection, fever, and rash. Severe side effects are rare but may include pneumonia, infection of the brain and/or spinal cord covering, or seizures. |
| Contraindications | People with severe allergies, severe primary or acquired immunodeficiency, or a family history of congenital hereditary immunodeficiency should not receive the vaccine. |
| Pregnancy | The vaccine is not recommended during pregnancy, but it has been given to pregnant women without causing problems. |
| HIV/AIDS | The vaccine should be used with caution in people with HIV/AIDS. The single-antigen vaccine may be administered to children with HIV infection if their CD4 percentage is ≥ 15. |
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What You'll Learn
Varicella vaccine effectiveness
The varicella vaccine, also known as the chickenpox vaccine, is highly effective in preventing the disease. The vaccine is available either by itself or along with the MMR vaccine, in a version known as the MMRV vaccine. The CDC recommends two doses of the vaccine for children, adolescents, and adults who do not have evidence of immunity. This is because two doses of the vaccine are more effective than one, with a pooled estimate of 92% effectiveness assessed five years after vaccination.
The first varicella vaccine was introduced in the US in 1995 with one dose, and subsequent years saw a reduction in cases of varicella. However, continued outbreaks in highly vaccinated populations and an increasing number of vaccine failures led to the recommendation of a second dose. A case-control study conducted from 1997 to 2003 showed that one dose of the vaccine was 97% effective in the first year after vaccination and 86% effective in the second year. From the second to the eighth year, effectiveness remained stable at 81% to 86%. In Navarre, Spain, a similar case-control study found that the effectiveness of one dose was 87%, while two doses were 97% effective.
The varicella vaccine is made from a weakened, live attenuated varicella-zoster virus, also known as the Oka strain. The vaccine is given by injection just under the skin and is generally safe and effective at protecting against chickenpox. However, it may not be suitable for everyone. People with HIV/AIDS or other diseases that affect the immune system, those receiving cancer treatment, pregnant women, and those who have recently had a transfusion may need to take extra precautions or refrain from getting the vaccine.
While the vaccine is highly effective, it does not guarantee complete protection. Breakthrough chickenpox can occur in vaccinated individuals, but symptoms are usually mild. Vaccinated people often experience fewer to no blisters and low or no fever, but red spots may occur. Additionally, vaccinating a large portion of the population also helps protect those who are not vaccinated. The World Health Organization (WHO) recommends routine vaccination only if a country can keep more than 80% of its population vaccinated.
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Who should not get vaccinated
The varicella vaccine, also known as the chickenpox vaccine, is generally recommended for children, adolescents, and adults who do not have evidence of immunity against the disease. However, there are certain individuals who should not receive the varicella vaccine or should consult a healthcare provider before vaccination.
People with impaired humoral immunity, such as those with hypogammaglobulinemia or dysgammaglobulinemia, should not receive the varicella vaccine. Additionally, individuals with HIV/AIDS or other diseases that affect the immune system should exercise caution. HIV-infected individuals who are eligible for vaccination should receive two doses of the single-antigen varicella vaccine (Varivax®) separated by a three-month interval. It is important to note that HIV-infected individuals should not receive the combination measles, mumps, rubella, and varicella vaccine (ProQuad®).
Pregnant women or those who may become pregnant should also avoid the varicella vaccine. Breastfeeding is not a contraindication for vaccination, but it is important to consult a healthcare provider for guidance. Furthermore, individuals who have recently received a blood transfusion or blood products, are undergoing cancer treatment, or are taking immunosuppressive medications should consult a healthcare provider before receiving the varicella vaccine.
In certain cases, vaccination may be recommended with close monitoring. For instance, children with rheumatoid arthritis or other conditions requiring therapeutic aspirin may benefit from vaccination despite the theoretical risk of Reye syndrome. Additionally, children with leukemia in remission and without immunity to varicella should be vaccinated under expert guidance and with access to antiviral therapy.
It is always advisable to consult a healthcare provider to determine if there are any specific contraindications or precautions that apply to an individual's health status before receiving the varicella vaccine.
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Side effects
The varicella vaccine, also known as the chickenpox vaccine, is a vaccine that protects against chickenpox. It is given by injection just under the skin. The varicella-zoster vaccine is made from the Oka/Merck strain of live attenuated varicella virus. The Oka virus was initially obtained from a child with natural varicella, introduced into human embryonic lung cell cultures, and finally propagated in a human diploid cell line originally derived from fetal tissues (WI-38).
The side effects of the varicella vaccine are usually mild, and severe reactions are rare. Minor side effects may include pain, redness, stiffness, and soreness at the site of injection, as well as fever and rash. A few people may develop a mild rash, which usually appears around the injection site. There is a short-term risk of developing herpes zoster (shingles) following vaccination. However, this risk is lower than the risk due to a natural infection resulting in chickenpox. Most of the cases reported have been mild and have not been associated with serious complications. Approximately 5% of children who receive the vaccine develop a fever or rash.
ProQuad, a vaccine that protects against chickenpox, measles, mumps, and rubella, has a slightly higher risk of causing a fever or febrile seizure as side effects when given as a first dose to children under 48 months. For this reason, the U.S. Centers for Disease Control and Prevention (CDC) recommends two separate shots (Varivax and MMR vaccine) at the same appointment for the first dose in children under 48 months.
The varicella vaccine is not recommended for people who are taking salicylates (e.g. aspirin). After receiving the varicella vaccine, the use of salicylates should be avoided for at least six weeks. It is also not recommended for individuals who have received a live vaccine in the last four weeks, as live vaccines administered too soon may not be as effective. The vaccine is not recommended for people who are taking medicine that weakens the immune system, including cancer medicine or steroid medicine. It is also not recommended during pregnancy, although the few times it has been given during pregnancy, no problems have resulted.
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History of the vaccine
Chickenpox, or Varicella, is a highly contagious disease caused by the varicella-zoster virus (VZV). In the past, it was almost a universal experience during childhood. Chickenpox is usually a mild disease in children, but serious cases can lead to complications such as pneumonia and neurological issues. Chickenpox can also be risky for pregnant women and their newborns.
The varicella vaccine, also known as the chickenpox vaccine, is a live, attenuated vaccine that protects against chickenpox. It was developed in the 1970s by Michiaki Takahashi and colleagues in Japan. The vaccine was derived from the Oka strain of the varicella virus. In 1981, American vaccinologist Maurice Hilleman and his team further developed a chickenpox vaccine based on the Oka strain. The chickenpox vaccine first became commercially available in 1984. It was first licensed for use in the US by Merck in 1995 under the brand name Varivax. In the same year, the vaccine was added to the childhood immunization schedule. A booster dose was added in 2006. The vaccine was licensed for use in Japan and Korea in 1988.
The varicella vaccine is given by injection just under the skin. It is available as a single vaccine or as part of the MMRV vaccine (measles, mumps, rubella, and varicella). The MMRV vaccine is only licensed for children between the ages of 1 and 12 years old. The vaccine is safe and effective, and two doses are recommended for children, adolescents, and adults who have never had chickenpox or received the vaccine. The doses should be at least 28 days apart. One dose of the vaccine prevents 95% of moderate cases of chickenpox and 100% of severe cases. Two doses are more effective than one.
Follow-up evaluations have been conducted in the United States and Japan, revealing that the vaccine provides protection for at least 11 years and 20 years, respectively. According to the World Health Organization (WHO), more than 90% of immunocompetent individuals vaccinated as children were still protected from varicella after 20 years of observation. The WHO recommends routine vaccination only if a country can maintain more than 80% vaccination coverage. If the vaccination coverage falls between 20% and 80%, there is a risk of more people contracting the disease at an older age, potentially worsening outcomes.
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The zoster vaccine
Chickenpox is a highly contagious disease caused by the varicella-zoster virus (VZV). The zoster vaccine, also known as the shingles vaccine, is used to prevent diseases caused by the same virus. It is important to note that the zoster vaccine is not used to prevent chickenpox.
Shingles is a painful rash illness caused by the varicella-zoster virus (VZV). After a person recovers from chickenpox, the virus can remain dormant in the body and reactivate years later, causing shingles. Shingles vaccination is the only way to protect against shingles and related complications. The vaccine is highly effective, with a success rate of over 90% in preventing shingles and postherpetic neuralgia in adults 50 and older with healthy immune systems.
The CDC recommends Shingrix, an FDA-approved vaccine, to prevent shingles and its complications in adults 50 and older. It is also recommended for adults 18 and older who are at an increased risk of shingles due to a weakened immune system. It is important to note that Shingrix is not indicated to prevent complications from shingles. The vaccine is given in two doses, with the second dose administered 2 to 6 months after the first. Completing both doses is necessary to achieve full protection.
Shingrix is available at most pharmacies without a prescription. Common side effects include pain, redness, and swelling at the injection site, muscle pain, tiredness, headache, shivering, fever, and upset stomach. It is important to note that fainting can occur after receiving the vaccine, so precautions should be taken to avoid injury. Pregnant or breastfeeding women should consult their healthcare provider before receiving the vaccine.
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Frequently asked questions
Yes, the single-antigen varicella vaccine does not include WI-38. The WI-38 cell strain is only found in the combination measles, mumps, rubella, and varicella (MMRV) vaccine.
The single-antigen vaccine only contains the varicella virus, while the MMRV vaccine contains a combination of measles, mumps, rubella, and varicella vaccines. The MMRV vaccine is only licensed for children aged 12 months to 12 years old.
The single-antigen vaccine is highly effective, with an efficacy rate of 70% to 90% after one dose and more than 95% effective for preventing severe varicella. Two doses are recommended for optimal protection, with a reported efficacy of 92% to 98%.
The single-antigen vaccine is recommended for people who do not have evidence of immunity to varicella and are likely to be exposed or transmit the virus. This includes individuals such as teachers, students, childcare workers, and healthcare workers. It is also suitable for people with HIV infection if specific conditions are met.
Minor side effects may include pain at the injection site, fever, and rash. Severe side effects are rare but can include pneumonia, infection of the brain and spinal cord covering, or seizures. Individuals with serious immune system problems should not receive the vaccine as it may cause a life-threatening infection.
