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Getting chickenpox used to be accepted as an unpleasant part of growing up. If your toddler didn't get it from a sibling or friend in the neighborhood, then there was a good chance he or she would get the disease when it came time to go to school.
Chickenpox, or varicella zoster virus, is highly contagious. Except for the discomfort of the nasty, itchy red spots it creates, chickenpox is generally considered harmless. Once children get it, you don't have to worry about them getting it again. Now, parents, you can do more than stand ready with the calamine lotion. You can act proactively and choose to have your child vaccinated against chickenpox.
Both the Centers for Disease Control and the Academy of Pediatrics Committee on Infectious Diseases recommend children receive the chickenpox vaccine at about 12 to 15 months of age. Most pediatricians and family doctors also recommend children be vaccinated against chickenpox. However, parents should know that the chickenpox vaccine isn't as effective as some of the other vaccines for childhood diseases. The fact is, about 10 percent to 30 percent of the children who receive the vaccination do not become immune to chickenpox.
How is chickenpox spread?
Chickenpox can be transmitted to others through fluid from broken blisters as well as by droplet infection, coughing or sneezing. A child who has caught chickenpox usually begins to have symptoms within 10 to 21 days of exposure. The classic signs of chickenpox are an itchy, blistery skin rash, sometimes accompanied by a low-grade fever. Blisters appear in crops over a two- to five-day period and eventually form crusts. Some children have only about 50 blisters, while others can develop more than 500. The illness usually runs its course in seven to 10 days.
A child is contagious from one or two days before the rash appears until the blisters have crusted over. The American Academy of Pediatrics advises that a child who has had chickenpox can go back to school six days after the onset of the rash or even sooner, if all the blisters are crusted over.
Can chickenpox be serious?
Generally, chickenpox is not a serious health threat. The rash, however, can be very itchy and scratching can lead to secondary infection by bacteria on the skin. Doctors advise trimming a child's nails very short to prevent scratching and using calamine lotion and tepid oatmeal baths to relieve the itching. Also, a non-aspirin medication, such as acetaminophen, may be used to reduce temperature and ease general aches and pains.
Call the doctor if your child develops a fever of 103 degrees F; if blisters are inflamed, painfully swollen, or filled with pus; or if the child is getting no relief from itching.
Most children return to normal in about two to three weeks. Children with weak immune systems, such as those with the HIV virus or cancer, are susceptible to complications, such as more serious secondary skin infections or, in rare cases, infections of the lung or central nervous system.
Getting vaccinated against chickenpox
The chickenpox vaccine is administered by an injection under the skin of the thigh or shoulder. Adverse reactions are usually mild and infrequent. Only about 20 percent of those who get immunized report pain and redness at the site of injection. (Generally, young children experience fewer side effects than adolescents and adults.)
Two injections of the vaccine are recommended for all children beginning at age 1 year and again between 4-6 years of age.
What are the concerns about the vaccine?
One of the primary concerns about the vaccine is that parents may be lulled into a false sense of security that their child is immune after receiving the vaccine. The chickenpox vaccine is not as effective as other vaccines. The measles vaccine, for example, confers immunity in about 97 percent of those who receive it, compared to the chickenpox vaccine, which provides immunity about 70 percent of the time.
Vaccinated children who come down with chickenpox months to years later generally have much milder cases than unvaccinated children. However, a susceptible child who becomes infected with chickenpox when he or she is older is at a higher risk for complications.
An antibody test can determine whether a child has received immunity from the chickenpox vaccine, but is not done as a matter of course.
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External Sources
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American Academy of Pediatrics
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Centers for Disease Control and Prevention
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This article was reviewed and updated June 2007.
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