Outbreaks

Data on the number of chickenpox (varicella) outbreaks that occur each year in the United States are limited. But, since the chickenpox vaccine was introduced, the number of outbreaks has gone down.

Chickenpox outbreaks continue to occur even in settings such as schools where most children are vaccinated with one dose. However, there have been fewer outbreaks reported ever since the two-dose chickenpox vaccination program started in the United States. Also, these outbreaks have been smaller. The vaccine may not prevent all chickenpox, but it is very effective at preventing severe cases.

Outbreak Surveillance, Investigation, and Control

Prompt identification, investigation, and control of chickenpox outbreaks are important. Even mild cases can be contagious. CDC works with state health departments to monitor chickenpox outbreaks. States are encouraged to report annual chickenpox outbreaks to CDC using the outbreak reporting worksheet [150 KB, 1 page].

For more information, see the Chapter on Varicella in the Manual for the Surveillance of Vaccine-Preventable Diseases.

Preventing and Controlling Chickenpox Outbreaks

Chickenpox vaccination is recommended for preventing and controlling outbreaks of chickenpox.

• People who do not have evidence of immunity to chickenpox should get a first or second dose of chickenpox vaccine as appropriate
• For outbreaks in preschool children, two doses of chickenpox vaccine are recommended for best protection
• Optimally, outbreak control efforts should be implemented as soon as a case is identified. Chickenpox vaccination should be offered even if the outbreak is identified late. Chickenpox outbreaks in some settings, for example, child care centers, schools, and institutions, can last as long as 4–5 months. Thus, offering chickenpox vaccine during an outbreak may provide protection to persons not yet exposed and shorten the duration of the outbreak.
• People who get their first or second dose of chickenpox vaccine as part of outbreak control measures may be immediately readmitted to school.
• People vaccinated with the first dose of chickenpox vaccine as part of outbreak control measures should be scheduled for the second dose as appropriate.

Guidelines and Resources

• Control & Investigation of Varicella Outbreaks
• Varicella Outbreak Reporting Worksheet [150 KB, 1 page]
• Specimen Collection Form

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