MARK B. LEVIN, M.D.
JOHN M. COTTON, M.D.
TIMOTHY J. PATRICK-MILLER, M.D.
LOUIS J. TESORO, M.D.
HELEN M. ROSE, M.D.
THE PEDIATRIC GROUP, P.A.
66 Mt. Lucas Road, Princeton, N.J. 08540-2733
tel: (609) 924-4892, fax: (609) 921-9380
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Varicella (Chicken Pox) Vaccine for Children
The State of New Jersey has recently mandated chicken pox (varicella) vaccine for all children born after January 1, 1998 who are entering day care, preschool, kindergarten or first grade unless they have had chicken pox or have laboratory evidence of immunity to the disease. This mandate becomes effective as of September 1, 2004. {www.state.nj.us/health/cd/imm_reg.pdf}
In 1974, varicella vaccine became available to prevent chicken pox in Japan. The vaccine was subsequently approved for use in the USA in the late 1990s. The vaccine is indicated for normal children twelve months of age and older who have not had chicken pox. Varicella vaccine is a live attenuated virus vaccine. Clinical trials have shown the vaccine to be both safe and effective, and long-term studies are ongoing. Following a single dose of vaccine in children less than thirteen years old, or a pair of injections one month apart in older patients, protection against the severest form of disease approximates 100 %. Against mild and moderate chicken pox, protection nears 80%.
Side effects are usually minor and include local inflammation (20-30 %, zero to two days after vaccination), rash resembling mild chicken pox (1-5 %, 5-26 days after vaccination averaging about five lesions), and fever (10-15 %). A small number of close contacts of recipients of the vaccine (less than 1 %) may contract a very mild case of chicken pox.
The vaccine can not be given to individuals with a severe allergy to gelatin or neomycin. Varicella vaccine should not be used in patients who are pregnant or lactating, immune compromised, have malignancies or certain blood diseases, or who have an illness with fever. Vaccine recipients should avoid pregnancy and exposure to high-risk individuals for three months, and salicylates (i.e., aspirin, Pepto-Bismol®) for six weeks. Reye Syndrome after varicella vaccine has not been reported.
Data about vaccination against varicella suggests that protection is unlikely to wane over time. Furthermore, since more children are being immunized, the chance of acquiring the infection in preadolescence is diminishing. The Centers for Disease Control and the Committee on Infectious Diseases of the American Academy of Pediatrics recommend that all children receive vaccination against chicken pox at twelve months of age. Those older than twelve months may receive the vaccine if they have not yet had chicken pox. Patients ten years and older who have not yet had chicken pox should certainly be vaccinated, as the risk of a complicated course from the disease increases markedly in adolescence and adulthood.
If your child has not yet had chicken pox, please contact our office regarding a time to come in for the vaccine. If you have any questions, please contact us.
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