Questions and links to answers:

1. Does the ACIP recommend routine varicella vaccination for children?
2. What children are eligible to receive it through VFC?
3. Is it recommended for adolescents and adults?
4. Are some groups of adults more susceptible?
5. Can children with acute lymphoblastic leukemia (ALL) receive the vaccine?
6. Should a child in the same household with a sibling with leukemia get vaccinated?
7. Can children with HIV / AIDS receive the vaccine?

Go to other pages of related questions:

• Varicella disease specific
• Vaccine specific
• Health care workers related
• Storage and handling
• Pregnancy related

1. Does the Advisory Committee on Immunization Practices (ACIP) recommend routine varicella vaccination for children?

Yes, ACIP recommends routine varicella vaccination for all children at 12-18 months of age and catch-up vaccination for all susceptible children older than 19 months of age.

For further information on the ACIP recommendations visit the following sites:

• ACIP recommendations:
  ftp://ftp.cdc.gov/pub/Publications/mmwr/RR/RR4511.pdf

• Updated ACIP recommendations:
  http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/rr4806a1.htm

2. What children are currently eligible to receive varicella vaccine through the Vaccines for Children (VFC) program?

All VFC-eligible children from 12 months of age through 18 years of age are eligible to receive varicella vaccine through the VFC program.

3. Is varicella vaccine recommended for adolescents and adults?

Yes, susceptible healthy adolescents and adults should receive varicella vaccine. Varicella is a more severe disease in adults. Despite the fact that adults account for only 5% of varicella cases per year, they account for a disproportionate number of deaths of deaths (55%) and hospitalizations (33%) compared to children.

4. Are there some groups of adults for whom varicella vaccination is especially important?

Yes, varicella vaccination is especially important for the following groups of susceptible adults

• persons who have close contact with persons at high risk for serious complications, for example health care workers and family members/close contacts of people with impaired immune systems;
• persons who live or work in environments in which VZV transmission is likely, for example teachers of young children, childcare employees, and residents/staff in institutional settings;
• persons who live or work in places where VZV transmission can readily occur, for example college students, inmates and staff of correctional institutions, and military personnel;
• nonpregnant women of childbearing age (women should avoid pregnancy for 1 month following each vaccine dose);
• adolescents and adults living in households with children; and
• international travelers.

However, all healthy susceptible adults should be vaccinated.

5. Can children with acute lymphoblastic leukemia (ALL) receive the vaccine?

Yes, vaccine is available to any physician free of charge from the manufacturer through a research protocol for use in patients who have ALL who

• are 12 months-17 years of age;
• have disease that has been in remission for at least 12 continuous months;
• have a negative history of varicella disease;
• have a peripheral blood-lymphocyte count of >700 cells/mm3; and
• have a platelet count of >100,000 cells/mm3 within 24 hours of vaccination.

The vaccine is well tolerated, immunogenic, and protective in children who meet these criteria. The most common reaction to the vaccine for ALL patients is a mild to moderate varicella-like rash (i.e., two to 200 lesions), which occurs in approximately 5% of children who have completed their chemotherapy before vaccination and 40% of vaccinees on maintenance chemotherapy. Children with ALL should receive two doses of the vaccine, 3 months apart. For more information about this protocol, contact Judy Birchler at (484) 679-2680 in Omnicare Clinical Research (Contact information updated March 25, 2002.)

For more information, visit the following site:
http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/rr4806a1.htm

6. Should varicella vaccine be administered to a healthy child who has an immunocompromised household contact, such as a sibling with leukemia?

ACIP and AAP recommend that healthy household contacts of immunocompromised persons be vaccinated. This is the most effective way to protect the immunocompromised person from varicella. However, because of the small risk of household transmission of vaccine virus, vaccinees who develop a vaccine-related rash should avoid contact with immunocompromised persons while the rash is present. If a susceptible immunocompromised person is inadvertently exposed to a person with a vaccine-related rash, varicella zoster immune globulin (VZIG) need not be given because disease associated with this type of transmission would be expected to be mild. It is preferable to expose the immunocompromised person to the much lower risk of severe disease due to vaccine virus than to wild virus in household contacts.

7. Can children with HIV / AIDS receive the vaccine?

On the basis of safety and immunogenicity data , the ACIP suggests that physicians consider vaccinating a subset of HIV-infected patients who are in CDC Class N1 or A1 and have an age-specific CD4% >25%. These children should receive 2 doses of the vaccine separated by 3 months. Another study is underway to examine use of the vaccine in HIV+ children with lower levels of cellular immune function. Depending upon the results of this study, the vaccine may be available to other children with HIV/AIDS in the future.

For more information, visit the following site:
http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/rr4806a1.htm

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