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Wikipedia

Varicella vaccine

May 05, 2023

Not to be confused with Variola vaccine.

Varicella vaccine, also known as chickenpox vaccine, is a vaccine that protects against chickenpox.[9] One dose of vaccine prevents 95% of moderate disease and 100% of severe disease.[10] Two doses of vaccine are more effective than one.[10] If given to those who are not immune within five days of exposure to chickenpox it prevents most cases of disease.[10] Vaccinating a large portion of the population also protects those who are not vaccinated.[10] It is given by injection just under the skin.[10] Another vaccine, known as zoster vaccine, is used to prevent diseases caused by the same virus – the varicella zoster virus.[11]

Varicella vaccine
Varicella vaccine
Vaccine description
TargetVaricella
Vaccine typeAttenuated
Clinical data
Trade namesVarivax, Varilrix, others
AHFS/Drugs.comMonograph
MedlinePlusa607029
License data
  • EU EMA: by varicella
Pregnancy
category
Routes of
administration		subcutaneous
ATC code
Legal status
Legal status
Identifiers
CAS Number
  • 934490-96-7 Y
DrugBank
  • DB10318 Y
ChemSpider
  • none
UNII
  • GPV39ZGD8C
 NY (what is this?)  (verify)

The World Health Organization (WHO) recommends routine vaccination only if a country can keep more than 80% of people vaccinated.[10] If only 20% to 80% of people are vaccinated it is possible that more people will get the disease at an older age and outcomes overall may worsen.[10] Either one or two doses of the vaccine is recommended.[10] In the United States two doses are recommended starting at twelve to fifteen months of age.[9] As of 2017, twenty-three countries recommend all non-medically exempt children receive the vaccine, nine recommend it only for high risk groups, three additional countries recommend use in only parts of the country, while other countries make no recommendation.[12] Not all countries provide the vaccine due to its cost.[13] In the United Kingdom, Varilrix, a live viral vaccine[14] is approved from the age of 12 months.

Minor side effects may include pain at the site of injection, fever, and rash.[9] Severe side effects are rare and occur mostly in those with poor immune function.[10] Its use in people with HIV/AIDS should be done with care.[10] It is not recommended during pregnancy; however, the few times it has been given during pregnancy no problems resulted.[9][10] The vaccine is available either by itself or along with the MMR vaccine, in a version known as the MMRV vaccine.[10] It is made from weakened virus.[9]

A live attenuated varicella vaccine, the Oka strain, was developed by Michiaki Takahashi and his colleagues in Japan in the early 1970s.[15] American vaccinologist Maurice Hilleman's team developed a chickenpox vaccine in the United States in 1981, based on the "Oka strain" of the varicella virus.[16][17][18] The chickenpox vaccine first became commercially available in 1984.[10] It is on the WHO Model List of Essential Medicines.[19][20]

Medical uses

Varicella vaccine is 70% to 90% effective for preventing varicella and more than 95% effective for preventing severe varicella.[21] Follow-up evaluations have taken place in the United States of children immunized that revealed protection for at least 11 years. Studies were conducted in Japan which indicated protection for at least 20 years.[21]

People who do not develop enough protection when they get the vaccine may develop a mild case of the disease when in close contact with a person with chickenpox. In these cases, people show very little sign of illness.[22] This has been the case of children who get the vaccine in their early childhood and later have contact with children with chickenpox. Some of these children may develop a mild chickenpox also known as breakthrough disease.[23]

Another vaccine, known as zoster vaccine, is simply a larger-than-normal dose of the same vaccine used against chickenpox, and is used in older adults to reduce the risk of shingles (also called herpes zoster) and postherpetic neuralgia, which are caused by the same virus.[11] The recombinant zoster (shingles) vaccine is recommended for adults aged 50 years and older.[24]

Duration of immunity

The long-term duration of protection from varicella vaccine is unknown, but there are now persons vaccinated twenty years ago with no evidence of waning immunity, while others have become vulnerable in as few as six years. Assessments of duration of immunity are complicated in an environment where natural disease is still common, which typically leads to an overestimation of effectiveness.[25]

Some vaccinated children have been found to lose their protective antibody in as little as five to eight years.[26] However, according to the World Health Organization (WHO): "After observation of study populations for periods of up to 20 years in Japan and 10 years in the United States, more than 90% of immunocompetent persons who were vaccinated as children were still protected from varicella." However, since only one out of five Japanese children were vaccinated, the annual exposure of these vaccinees to children with natural chickenpox boosted the vaccinees' immune system. In the United States, where universal varicella vaccination has been practiced, the majority of children no longer receive exogenous (outside) boosting, thus, their cell-mediated immunity to VZV (varicella zoster virus) wanes – necessitating booster chickenpox vaccinations.[27] As time goes on, boosters may be necessary. Persons exposed to the virus after vaccination tend to experience milder cases of chickenpox if they develop the disease.[28]

Catching "wild" chickenpox as a child has been thought to commonly result in lifelong immunity. Indeed, parents have deliberately ensured this in the past with "pox parties". Historically, exposure of adults to contagious children has boosted their immunity, reducing the risk of shingles.[29] The US Centers for Disease Control and Prevention (CDC) and corresponding national organizations are carefully observing the failure rate which may be high compared with other modern vaccines – large outbreaks of chickenpox having occurred at schools which required their children to be vaccinated.[30]

Chickenpox

Prior to the widespread introduction of the vaccine in the United States in 1995 (1986 in Japan and 1988 in Korea[31]), there were around 4,000,000 cases per year in the United States, mostly in children, with typically 10,500–13,000 hospital admissions (range, 8,000–18,000), and 100–150 deaths each year.[31][27][10][32] Most of the deaths were among young children.[33]

During 2003, and the first half of 2004, the CDC reported eight deaths from varicella, six of whom were children or adolescents. These deaths and hospital admissions have substantially declined in the US due to vaccination,[34][35] though the rate of shingles infection has increased as adults are less exposed to infected children (which would otherwise help protect against shingles).[36][37][38] Ten years after the vaccine was recommended in the US, the CDC reported as much as a 90% drop in chickenpox cases, a varicella-related hospital admission decline of 71%[32] and a 97% drop in chickenpox deaths among those under 20.[39]

Vaccines are less effective among high-risk patients, as well as being more dangerous because they contain attenuated live virus. In a study performed on children with an impaired immune system, 30% had lost the antibody after five years, and 8% had already caught wild chickenpox in that five-year period.[40]

Herpes zoster

Herpes zoster (shingles) most often occurs in the elderly and is only rarely seen in children. The incidence of herpes zoster in vaccinated adults is 0.9/1000 person-years, and is 0.33/1000 person-years in vaccinated children; this is lower than the overall incidence of 3.2–4.2/1000 person-years.[41][42]

The risk of developing shingles is reduced for children who receive the varicella vaccine, but not eliminated.[43] The CDC stated in 2014: "Chickenpox vaccines contain weakened live VZV, which may cause latent (dormant) infection. The vaccine-strain VZV can reactivate later in life and cause shingles. However, the risk of getting shingles from vaccine-strain VZV after chickenpox vaccination is much lower than getting shingles after natural infection with wild-type VZV."[44]

The risk of shingles is significantly lower among children who have received varicella vaccination, including those who are immunocompromised. The risk of shingles is approximately 80% lower among healthy vaccinated children compared to unvaccinated children who had wild-type varicella.[43][45] A population with high varicella vaccination also has lower incidents of shingles in unvaccinated children, due to herd immunity.[45]

Schedule

The WHO recommends one or two doses with the initial dose given at 12 to 18 months of age.[10] The second dose, if given, should occur at least one to three months later.[10] The second dose, if given, provides the additional benefit of improved protection against all varicella.[46] This vaccine is a shot given subcutaneously (under the skin). It is recommended for all children under 13 and for everyone 13 or older who has never had chickenpox.[47]

In the United States, two doses are recommended by the CDC. For a routine vaccination, the first dose is administered at 12 to 15 months of age and a second dose at age 4–6 years. However, the second dose can be given as early as 3 months after the first dose. If an individual misses the timing for the routine vaccination, the individual is eligible to receive a catch-up vaccination. For a catch-up vaccination, individuals between 7 and 12 years old should receive a two-dose series 3 months apart (a minimum interval of 4 weeks). For individuals 13–18 years old, the catch-up vaccination should be given 4 to 8 weeks apart (a minimum interval of 4 weeks).[48] The varicella vaccine did not become widely available in the United States until 1995.[49]

In the UK, the vaccine is only recommended for those who are in close contact with someone who is particularly vulnerable to chickenpox.[50] As there is an increased risk of shingles in adults due to possible lack of contact with chickenpox-infected children providing a natural boosting to immunity, and the fact that chickenpox is usually a mild illness, the National Health Service cites concerns about unvaccinated children catching chickenpox as adults when it is more dangerous.[50]

Contraindications

The varicella vaccine is not recommended for seriously ill people, pregnant women, people who have tuberculosis, people who have experienced a serious allergic reaction to the varicella vaccine in the past, people who are allergic to gelatin, people allergic to neomycin, people receiving high doses of steroids, people receiving treatment for cancer with x-rays or chemotherapy, as well as people who have received blood products or transfusions during the past five months.[51][52] Additionally, the varicella vaccine is not recommended for people who are taking salicylates (e.g. aspirin).[52] After receiving the varicella vaccine, the use of salicylates should be avoided for at least six weeks.[52] The varicella vaccine is also not recommended for individuals who have received a live vaccine in the last four weeks,[52] because live vaccines that are administered too soon within one another may not be as effective.[52] It may be usable in people with HIV infections who have a good blood count and are receiving appropriate treatment.[10] Specific antiviral medication, such as acyclovir, famciclovir, or valacyclovir, are not recommended 24 hours before and 14 days after vaccination.[53]

Side effects

Serious side effects are very rare. From 1998 to 2013, only one vaccine-related death was reported: an English child with pre-existent leukemia. On some occasions, severe reactions such as meningitis and pneumonia have been reported (mainly in inadvertently vaccinated immunocompromised children) as well as anaphylaxis.[41]

The possible mild side effects include redness, stiffness, and soreness at the injection site, as well as fever. A few people may develop a mild rash, which usually appears around the injection site.[54]

There is a short-term risk of developing herpes zoster (shingles) following vaccination. However, this risk is less than the risk due to a natural infection resulting in chickenpox.[55]: 378  Most of the cases reported have been mild and have not been associated with serious complications.[56]

Approximately 5% of children who receive the vaccine develop a fever or rash. Adverse reaction reports for the period 1995 to 2005 found no deaths attributed to the vaccine despite approximately 55.7 million doses being delivered.[57] Cases of vaccine-related chickenpox have been reported in patients with a weakened immune system,[58][59] but no deaths.

The literature contains several reports of adverse reactions following varicella vaccination, including vaccine-strain zoster in children and adults.[60]

History

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, adapted to and propagated in embryonic guinea pig cell cultures, and finally propagated in a human diploid cell line originally derived from fetal tissues (WI-38).[4][5][6] Takahashi and his colleagues used the Oka strain to develop a live attenuated varicella vaccine in Japan in the early 1970s.[15] This strain was further developed by pharmaceutical companies such as Merck & Co. and GlaxoSmithKline.[61] American vaccinologist Maurice Hilleman's team at Merck then used the Oka strain to prepare a chickenpox vaccine in 1981.[16][17][18]

Japan was among the first countries to vaccinate for chickenpox. The vaccine developed by Hilleman was first licensed in the United States in 1995.[16][62] Routine vaccination against varicella zoster virus is also performed in the United States, and the incidence of chickenpox has been dramatically reduced there (from four million cases per year in the pre-vaccine era to approximately 390,000 cases per year as of 2014).[63]

As of 2019, standalone varicella vaccines are available in all 27 European Union member countries, and 16 countries also offer a combined measles, mumps, rubella and varicella vaccine (MMRV).[64] Twelve European countries (Austria, Andorra, Cyprus, Czech Republic, Finland, Germany, Greece, Hungary, Italy, Latvia, Luxembourg and Spain) have universal varicella vaccination (UVV) policies, though it is only six of these countries have made it available at no cost via government funding.[64] EU member states that have not implemented UVV cite reasons such as "a perceived low disease burden and low public health priority," the cost and cost-effectiveness, the possible risk of herpes zoster when vaccinating older adults, and rare fevers leading to seizures after the first dose of the MMRV vaccine.[64] "Countries that implemented UVV experienced decreases in varicella incidence, hospitalizations and complications, showing overall beneficial impact."[64]

Varicella vaccination is recommended in Canada for all healthy children aged 1 to 12, as well as susceptible adolescents and adults 50 years of age and younger; "may be considered for people with select immunodeficiency disorders;[22] and "should be prioritized" for susceptible individuals, including "non-pregnant women of childbearing age, Household contacts of immunocompromised individuals, Members of a household expecting a newborn, Health care workers, Adults who may be exposed occupationally to varicella (for example, people who work with young children), Immigrants and refugees from tropical regions, People receiving chronic salicylate therapy (for example, acetylsalicylic acid [ASA])," and others.[65]

Australia has adopted recommendations for routine immunization of children and susceptible adults against chickenpox.[66]

Other countries, such as the United Kingdom, have targeted recommendations for the vaccine, e.g., for susceptible health care workers at risk of varicella exposure. In the UK, varicella antibodies are measured as part of the routine of prenatal care, and by 2005 all National Health Service personnel had determined their immunity and been immunized if they were non-immune and have direct patient contact. Population-based immunization against varicella is not otherwise practised in the UK.[67]

Since 2013, the MMRV vaccine is offered for free to all Brazilian citizens.[68]

Society and culture

Catholic Church

Main article: Use of fetal tissue in vaccine development § Position of the Catholic Church

The Roman Catholic Church is opposed to abortion. Nevertheless, the Pontifical Academy for Life stated in 2017 that "clinically recommended vaccinations can be used with a clear conscience and that the use of such vaccines does not signify some sort of cooperation with voluntary abortion".[69] On 21 December 2020, the Vatican's doctrinal office, the Congregation for the Doctrine of the Faith, further clarified that it is "morally licit" for Catholics to receive vaccines derived from fetal cell lines or in which such lines were used in testing or development, because "passive material cooperation in the procured abortion from which these cell lines originate is, on the part of those making use of the resulting vaccines, remote" and "does not and should not in any way imply that there is a moral endorsement of the use of cell lines proceeding from aborted fetuses".[70]

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  64. ^ a b c d Spoulou V, Alain S, Gabutti G, Giaquinto C, Liese J, Martinon-Torres F, Vesikari T (February 2019). "Implementing Universal Varicella Vaccination in Europe: The Path Forward". Pediatr Infect Dis J. 38 (2): 181–188. doi:10.1097/INF.0000000000002233. hdl:11392/2400466. PMID 30408002. S2CID 53239234. Retrieved 3 October 2021.
  65. ^ "Varicella (chickenpox) vaccine: Canadian Immunization Guide For health professionals". Canadian Immunization Guide. Health Canada. July 2018. Retrieved 3 October 2021.
  66. ^ "Chickenpox immunisation service". health.gov.au. 15 April 2021. Retrieved 26 October 2021.
  67. ^ "Chickenpox vaccine FAQs". NHS.uk. 31 July 2019. Retrieved 1 April 2020.
  68. ^ Scotta, Marcelo Comerlato; Paternina-de la Ossa, Rolando; et al. (2018). "Early impact of universal varicella vaccination on childhood varicella and herpes zoster hospitalizations in Brazil". Vaccine. 36 (2): 280–284. doi:10.1016/j.vaccine.2017.11.057. PMID 29198917.
  69. ^ "Note on Italian vaccine issue". www.academyforlife.va. Retrieved 3 October 2021.
  70. ^ Congregation for the Doctrine of the Faith (21 December 2020). "Note of the Congregation for the Doctrine of the Faith on the morality of using some anti-Covid-19 vaccines, 21.12.2020". Summary of Bulletin, Holy See Press Office. Holy See.

Further reading

  • World Health Organization (May 2008). The immunological basis for immunization series : Module 10: Varicella-zoster virus. World Health Organization (WHO). hdl:10665/43906. ISBN 978-9241596770.
  • Ramsay M, ed. (March 2013). "Chapter 34: Varicella". Immunisation against infectious disease. Gov.uk. Public Health England.
  • Hall E, Wodi AP, Hamborsky J, Morelli V, Schillie S, eds. (2021). "Chapter 22: Varicella". Epidemiology and Prevention of Vaccine-Preventable Diseases (14th ed.). Washington D.C.: U.S. Centers for Disease Control and Prevention (CDC).`
  • Roush SW, Baldy LM, Hall MA, eds. (9 January 2020). "Chapter 17: Varicella". Manual for the surveillance of vaccine-preventable diseases. Atlanta GA: Centers for Disease Control and Prevention (CDC).

External links

May 05, 2023
varicella, vaccine, confused, with, variola, vaccine, also, known, chickenpox, vaccine, vaccine, that, protects, against, chickenpox, dose, vaccine, prevents, moderate, disease, severe, disease, doses, vaccine, more, effective, than, given, those, immune, with. Not to be confused with Variola vaccine Varicella vaccine also known as chickenpox vaccine is a vaccine that protects against chickenpox 9 One dose of vaccine prevents 95 of moderate disease and 100 of severe disease 10 Two doses of vaccine are more effective than one 10 If given to those who are not immune within five days of exposure to chickenpox it prevents most cases of disease 10 Vaccinating a large portion of the population also protects those who are not vaccinated 10 It is given by injection just under the skin 10 Another vaccine known as zoster vaccine is used to prevent diseases caused by the same virus the varicella zoster virus 11 Varicella vaccineVaricella vaccineVaccine descriptionTargetVaricellaVaccine typeAttenuatedClinical dataTrade namesVarivax Varilrix othersAHFS Drugs comMonographMedlinePlusa607029License dataEU EMA by varicellaPregnancycategoryAU B2 1 Routes ofadministrationsubcutaneousATC codeJ07BK01 WHO J07BK02 WHO J07BK03 WHO Legal statusLegal statusAU S4 Prescription only UK POM Prescription only 2 3 US only 4 5 6 EU Rx only 7 8 In general Prescription only IdentifiersCAS Number934490 96 7 YDrugBankDB10318 YChemSpidernoneUNIIGPV39ZGD8C N Y what is this verify The World Health Organization WHO recommends routine vaccination only if a country can keep more than 80 of people vaccinated 10 If only 20 to 80 of people are vaccinated it is possible that more people will get the disease at an older age and outcomes overall may worsen 10 Either one or two doses of the vaccine is recommended 10 In the United States two doses are recommended starting at twelve to fifteen months of age 9 As of 2017 update twenty three countries recommend all non medically exempt children receive the vaccine nine recommend it only for high risk groups three additional countries recommend use in only parts of the country while other countries make no recommendation 12 Not all countries provide the vaccine due to its cost 13 In the United Kingdom Varilrix a live viral vaccine 14 is approved from the age of 12 months Minor side effects may include pain at the site of injection fever and rash 9 Severe side effects are rare and occur mostly in those with poor immune function 10 Its use in people with HIV AIDS should be done with care 10 It is not recommended during pregnancy however the few times it has been given during pregnancy no problems resulted 9 10 The vaccine is available either by itself or along with the MMR vaccine in a version known as the MMRV vaccine 10 It is made from weakened virus 9 A live attenuated varicella vaccine the Oka strain was developed by Michiaki Takahashi and his colleagues in Japan in the early 1970s 15 American vaccinologist Maurice Hilleman s team developed a chickenpox vaccine in the United States in 1981 based on the Oka strain of the varicella virus 16 17 18 The chickenpox vaccine first became commercially available in 1984 10 It is on the WHO Model List of Essential Medicines 19 20 Contents 1 Medical uses 1 1 Duration of immunity 1 2 Chickenpox 1 3 Herpes zoster 1 4 Schedule 2 Contraindications 3 Side effects 4 History 5 Society and culture 5 1 Catholic Church 6 References 7 Further reading 8 External linksMedical uses EditVaricella vaccine is 70 to 90 effective for preventing varicella and more than 95 effective for preventing severe varicella 21 Follow up evaluations have taken place in the United States of children immunized that revealed protection for at least 11 years Studies were conducted in Japan which indicated protection for at least 20 years 21 People who do not develop enough protection when they get the vaccine may develop a mild case of the disease when in close contact with a person with chickenpox In these cases people show very little sign of illness 22 This has been the case of children who get the vaccine in their early childhood and later have contact with children with chickenpox Some of these children may develop a mild chickenpox also known as breakthrough disease 23 Another vaccine known as zoster vaccine is simply a larger than normal dose of the same vaccine used against chickenpox and is used in older adults to reduce the risk of shingles also called herpes zoster and postherpetic neuralgia which are caused by the same virus 11 The recombinant zoster shingles vaccine is recommended for adults aged 50 years and older 24 Duration of immunity Edit The long term duration of protection from varicella vaccine is unknown but there are now persons vaccinated twenty years ago with no evidence of waning immunity while others have become vulnerable in as few as six years Assessments of duration of immunity are complicated in an environment where natural disease is still common which typically leads to an overestimation of effectiveness 25 Some vaccinated children have been found to lose their protective antibody in as little as five to eight years 26 However according to the World Health Organization WHO After observation of study populations for periods of up to 20 years in Japan and 10 years in the United States more than 90 of immunocompetent persons who were vaccinated as children were still protected from varicella However since only one out of five Japanese children were vaccinated the annual exposure of these vaccinees to children with natural chickenpox boosted the vaccinees immune system In the United States where universal varicella vaccination has been practiced the majority of children no longer receive exogenous outside boosting thus their cell mediated immunity to VZV varicella zoster virus wanes necessitating booster chickenpox vaccinations 27 As time goes on boosters may be necessary Persons exposed to the virus after vaccination tend to experience milder cases of chickenpox if they develop the disease 28 Catching wild chickenpox as a child has been thought to commonly result in lifelong immunity Indeed parents have deliberately ensured this in the past with pox parties Historically exposure of adults to contagious children has boosted their immunity reducing the risk of shingles 29 The US Centers for Disease Control and Prevention CDC and corresponding national organizations are carefully observing the failure rate which may be high compared with other modern vaccines large outbreaks of chickenpox having occurred at schools which required their children to be vaccinated 30 Chickenpox Edit Prior to the widespread introduction of the vaccine in the United States in 1995 1986 in Japan and 1988 in Korea 31 there were around 4 000 000 cases per year in the United States mostly in children with typically 10 500 13 000 hospital admissions range 8 000 18 000 and 100 150 deaths each year 31 27 10 32 Most of the deaths were among young children 33 During 2003 and the first half of 2004 the CDC reported eight deaths from varicella six of whom were children or adolescents These deaths and hospital admissions have substantially declined in the US due to vaccination 34 35 though the rate of shingles infection has increased as adults are less exposed to infected children which would otherwise help protect against shingles 36 37 38 Ten years after the vaccine was recommended in the US the CDC reported as much as a 90 drop in chickenpox cases a varicella related hospital admission decline of 71 32 and a 97 drop in chickenpox deaths among those under 20 39 Vaccines are less effective among high risk patients as well as being more dangerous because they contain attenuated live virus In a study performed on children with an impaired immune system 30 had lost the antibody after five years and 8 had already caught wild chickenpox in that five year period 40 Herpes zoster Edit Herpes zoster shingles most often occurs in the elderly and is only rarely seen in children The incidence of herpes zoster in vaccinated adults is 0 9 1000 person years and is 0 33 1000 person years in vaccinated children this is lower than the overall incidence of 3 2 4 2 1000 person years 41 42 The risk of developing shingles is reduced for children who receive the varicella vaccine but not eliminated 43 The CDC stated in 2014 Chickenpox vaccines contain weakened live VZV which may cause latent dormant infection The vaccine strain VZV can reactivate later in life and cause shingles However the risk of getting shingles from vaccine strain VZV after chickenpox vaccination is much lower than getting shingles after natural infection with wild type VZV 44 The risk of shingles is significantly lower among children who have received varicella vaccination including those who are immunocompromised The risk of shingles is approximately 80 lower among healthy vaccinated children compared to unvaccinated children who had wild type varicella 43 45 A population with high varicella vaccination also has lower incidents of shingles in unvaccinated children due to herd immunity 45 Schedule Edit The WHO recommends one or two doses with the initial dose given at 12 to 18 months of age 10 The second dose if given should occur at least one to three months later 10 The second dose if given provides the additional benefit of improved protection against all varicella 46 This vaccine is a shot given subcutaneously under the skin It is recommended for all children under 13 and for everyone 13 or older who has never had chickenpox 47 In the United States two doses are recommended by the CDC For a routine vaccination the first dose is administered at 12 to 15 months of age and a second dose at age 4 6 years However the second dose can be given as early as 3 months after the first dose If an individual misses the timing for the routine vaccination the individual is eligible to receive a catch up vaccination For a catch up vaccination individuals between 7 and 12 years old should receive a two dose series 3 months apart a minimum interval of 4 weeks For individuals 13 18 years old the catch up vaccination should be given 4 to 8 weeks apart a minimum interval of 4 weeks 48 The varicella vaccine did not become widely available in the United States until 1995 49 In the UK the vaccine is only recommended for those who are in close contact with someone who is particularly vulnerable to chickenpox 50 As there is an increased risk of shingles in adults due to possible lack of contact with chickenpox infected children providing a natural boosting to immunity and the fact that chickenpox is usually a mild illness the National Health Service cites concerns about unvaccinated children catching chickenpox as adults when it is more dangerous 50 Contraindications EditThe varicella vaccine is not recommended for seriously ill people pregnant women people who have tuberculosis people who have experienced a serious allergic reaction to the varicella vaccine in the past people who are allergic to gelatin people allergic to neomycin people receiving high doses of steroids people receiving treatment for cancer with x rays or chemotherapy as well as people who have received blood products or transfusions during the past five months 51 52 Additionally the varicella vaccine is not recommended for people who are taking salicylates e g aspirin 52 After receiving the varicella vaccine the use of salicylates should be avoided for at least six weeks 52 The varicella vaccine is also not recommended for individuals who have received a live vaccine in the last four weeks 52 because live vaccines that are administered too soon within one another may not be as effective 52 It may be usable in people with HIV infections who have a good blood count and are receiving appropriate treatment 10 Specific antiviral medication such as acyclovir famciclovir or valacyclovir are not recommended 24 hours before and 14 days after vaccination 53 Side effects EditSerious side effects are very rare From 1998 to 2013 only one vaccine related death was reported an English child with pre existent leukemia On some occasions severe reactions such as meningitis and pneumonia have been reported mainly in inadvertently vaccinated immunocompromised children as well as anaphylaxis 41 The possible mild side effects include redness stiffness and soreness at the injection site as well as fever A few people may develop a mild rash which usually appears around the injection site 54 There is a short term risk of developing herpes zoster shingles following vaccination However this risk is less than the risk due to a natural infection resulting in chickenpox 55 378 Most of the cases reported have been mild and have not been associated with serious complications 56 Approximately 5 of children who receive the vaccine develop a fever or rash Adverse reaction reports for the period 1995 to 2005 found no deaths attributed to the vaccine despite approximately 55 7 million doses being delivered 57 Cases of vaccine related chickenpox have been reported in patients with a weakened immune system 58 59 but no deaths The literature contains several reports of adverse reactions following varicella vaccination including vaccine strain zoster in children and adults 60 History EditThe 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 adapted to and propagated in embryonic guinea pig cell cultures and finally propagated in a human diploid cell line originally derived from fetal tissues WI 38 4 5 6 Takahashi and his colleagues used the Oka strain to develop a live attenuated varicella vaccine in Japan in the early 1970s 15 This strain was further developed by pharmaceutical companies such as Merck amp Co and GlaxoSmithKline 61 American vaccinologist Maurice Hilleman s team at Merck then used the Oka strain to prepare a chickenpox vaccine in 1981 16 17 18 Japan was among the first countries to vaccinate for chickenpox The vaccine developed by Hilleman was first licensed in the United States in 1995 16 62 Routine vaccination against varicella zoster virus is also performed in the United States and the incidence of chickenpox has been dramatically reduced there from four million cases per year in the pre vaccine era to approximately 390 000 cases per year as of 2014 update 63 As of 2019 standalone varicella vaccines are available in all 27 European Union member countries and 16 countries also offer a combined measles mumps rubella and varicella vaccine MMRV 64 Twelve European countries Austria Andorra Cyprus Czech Republic Finland Germany Greece Hungary Italy Latvia Luxembourg and Spain have universal varicella vaccination UVV policies though it is only six of these countries have made it available at no cost via government funding 64 EU member states that have not implemented UVV cite reasons such as a perceived low disease burden and low public health priority the cost and cost effectiveness the possible risk of herpes zoster when vaccinating older adults and rare fevers leading to seizures after the first dose of the MMRV vaccine 64 Countries that implemented UVV experienced decreases in varicella incidence hospitalizations and complications showing overall beneficial impact 64 Varicella vaccination is recommended in Canada for all healthy children aged 1 to 12 as well as susceptible adolescents and adults 50 years of age and younger may be considered for people with select immunodeficiency disorders 22 and should be prioritized for susceptible individuals including non pregnant women of childbearing age Household contacts of immunocompromised individuals Members of a household expecting a newborn Health care workers Adults who may be exposed occupationally to varicella for example people who work with young children Immigrants and refugees from tropical regions People receiving chronic salicylate therapy for example acetylsalicylic acid ASA and others 65 Australia has adopted recommendations for routine immunization of children and susceptible adults against chickenpox 66 Other countries such as the United Kingdom have targeted recommendations for the vaccine e g for susceptible health care workers at risk of varicella exposure In the UK varicella antibodies are measured as part of the routine of prenatal care and by 2005 all National Health Service personnel had determined their immunity and been immunized if they were non immune and have direct patient contact Population based immunization against varicella is not otherwise practised in the UK 67 Since 2013 the MMRV vaccine is offered for free to all Brazilian citizens 68 Society and culture EditCatholic Church Edit Main article Use of fetal tissue in vaccine development Position of the Catholic Church The Roman Catholic Church is opposed to abortion Nevertheless the Pontifical Academy for Life stated in 2017 that clinically recommended vaccinations can be used with a clear conscience and that the use of such vaccines does not signify some sort of cooperation with voluntary abortion 69 On 21 December 2020 the Vatican s doctrinal office the Congregation for the Doctrine of the Faith further clarified that it is morally licit for Catholics to receive vaccines derived from fetal cell lines or in which such lines were used in testing or development because passive material cooperation in the procured abortion from which these cell lines originate is on the part of those making use of the resulting vaccines remote and does not and should not in any way imply that there is a moral endorsement of the use of cell lines proceeding from aborted fetuses 70 References Edit Varicella virus vaccine Varivax Use During Pregnancy Drugs com 6 February 2019 Retrieved 28 December 2019 Varivax Summary of Product Characteristics SmPC emc 29 November 2018 Retrieved 28 December 2019 Varilrix 10 3 3 PFU 0 5ml powder and solvent for solution for injection Summary of Product Characteristics SmPC emc 20 February 2020 Retrieved 27 February 2021 a b Varivax varicella virus vaccine live injection powder lyophilized for 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sclerokeratitis and anterior uveitis in a child following varicella vaccination American Journal of Ophthalmology 135 3 415 417 doi 10 1016 S0002 9394 02 01957 8 PMID 12614776 Schwab J Ryan M August 2004 Varicella zoster virus meningitis in a previously immunized child Pediatrics 114 2 e273 e274 doi 10 1542 peds 114 2 e273 PMID 15286270 Bronstein DE Cotliar J Votava Smith JK Powell MZ Miller MJ Cherry JD March 2005 Recurrent papular urticaria after varicella immunization in a fifteen month old girl The Pediatric Infectious Disease Journal 24 3 269 270 doi 10 1097 01 inf 0000154330 47509 42 PMID 15750467 Binder NR Holland GN Hosea S Silverberg ML December 2005 Herpes zoster ophthalmicus in an otherwise healthy child Journal of AAPOS 9 6 597 598 doi 10 1016 j jaapos 2005 06 009 PMID 16414532 Tillieux SL Halsey WS Thomas ES Voycik JJ Sathe GM Vassilev V November 2008 Complete DNA sequences of two oka strain varicella zoster virus genomes Journal of Virology 82 22 11023 11044 doi 10 1128 JVI 00777 08 PMC 2573284 PMID 18787000 Varicella chickenpox Questions and Answers PDF Retrieved 23 April 2023 Lopez Adriana S Zhang John Marin Mona 2016 Epidemiology of Varicella During the 2 Dose Varicella Vaccination Program United States 2005 2014 Morbidity and Mortality Weekly Report 65 34 902 905 doi 10 15585 mmwr mm6534a4 PMID 27584717 a b c d Spoulou V Alain S Gabutti G Giaquinto C Liese J Martinon Torres F Vesikari T February 2019 Implementing Universal Varicella Vaccination in Europe The Path Forward Pediatr Infect Dis J 38 2 181 188 doi 10 1097 INF 0000000000002233 hdl 11392 2400466 PMID 30408002 S2CID 53239234 Retrieved 3 October 2021 Varicella chickenpox vaccine Canadian Immunization Guide For health professionals Canadian Immunization Guide Health Canada July 2018 Retrieved 3 October 2021 Chickenpox immunisation service health gov au 15 April 2021 Retrieved 26 October 2021 Chickenpox vaccine FAQs NHS uk 31 July 2019 Retrieved 1 April 2020 Scotta Marcelo Comerlato Paternina de la Ossa Rolando et al 2018 Early impact of universal varicella vaccination on childhood varicella and herpes zoster hospitalizations in Brazil Vaccine 36 2 280 284 doi 10 1016 j vaccine 2017 11 057 PMID 29198917 Note on Italian vaccine issue www academyforlife va Retrieved 3 October 2021 Congregation for the Doctrine of the Faith 21 December 2020 Note of the Congregation for the Doctrine of the Faith on the morality of using some anti Covid 19 vaccines 21 12 2020 Summary of Bulletin Holy See Press Office Holy See Further reading EditWorld Health Organization May 2008 The immunological basis for immunization series Module 10 Varicella zoster virus World Health Organization WHO hdl 10665 43906 ISBN 978 9241596770 Ramsay M ed March 2013 Chapter 34 Varicella Immunisation against infectious disease Gov uk Public Health England Hall E Wodi AP Hamborsky J Morelli V Schillie S eds 2021 Chapter 22 Varicella Epidemiology and Prevention of Vaccine Preventable Diseases 14th ed Washington D C U S Centers for Disease Control and Prevention CDC Roush SW Baldy LM Hall MA eds 9 January 2020 Chapter 17 Varicella Manual for the surveillance of vaccine preventable diseases Atlanta GA Centers for Disease Control and Prevention CDC External links Edit Chickenpox Vaccine Information Statement U S Centers for Disease Control and Prevention CDC 10 August 2021 Chickenpox Varicella Vaccination U S Centers for Disease Control and Prevention CDC 25 February 2021 Chickenpox Vaccine at the U S National Library of Medicine Medical Subject Headings MeSH Portals Medicine Viruses Retrieved from https en wikipedia org w index php title Varicella vaccine amp oldid 1151379562, wikipedia, wiki, book, books, library,

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