Chickenpox Vaccination: Pros and Cons

Chickenpox , or varicella, is considered one of the more harmless childhood diseases , which is transmitted by smear or droplet infection and whose pathogens enter the human organism via the conjunctiva of the eye or the upper respiratory tract. Because the virus is so easily transmitted, it is very likely to be contracted through contact with infected people. To prevent this, you can consider giving your child a chickenpox vaccine.

What is the benefit of the chickenpox vaccination?

There are several reasons that speak in favor of the vaccination recommended by the STIKO and the associated prevention of an infection with chickenpox viruses:

• The most common complication associated with chickenpox is bacterial inflammation of the characteristic rash. Raised pustules can get bacteria into the bloodstream, which in severe cases can cause blood poisoning. Complications such as inflammation of the middle ear or pneumonia can occur, especially in adulthood. In rare cases, an inflammation of the brain, known as chickenpox encephalitis, can also occur. This can be prevented with an early chickenpox vaccination.
• The varicella-zoster virus, which is the trigger of chickenpox, is not only highly contagious, but also remains in the cells of the immune or nervous system even after the disease has passed. As a result, another infection and the outbreak of shingles can occur years after the actual infection, especially at an advanced age.
• Chickenpox infection can also occur during pregnancygetting dangerous. If pregnant women contract chickenpox between the 13th and 20th week of pregnancy, there is a risk that the unborn child will develop malformations. Even a few days before birth, a chickenpox infection can be dangerous for the child. In the short time before birth, the mother’s immune system cannot develop enough antibodies against the virus to give the baby sufficient nest protection. In such a case, the newborn is usually affected by a very severe chickenpox infection, which must then be counteracted with an immediate passive vaccination. If chickenpox is infected between the 21st week and the week before birth, there is no direct risk for the unborn child,

STIKO recommends chickenpox vaccination from the 12th month

The STIKO recommends starting the vaccination against the chickenpox pathogen from the age of eleven months. The second partial vaccination, which is recommended to complete the vaccination protection, should be carried out in the second year of life, but no earlier than six weeks after the first chickenpox vaccination. You can find all STIKO vaccination recommendations in our vaccination calendar .

Catch up on chickenpox vaccination in school and adulthood?

In addition, according to STIKO, it makes sense for certain groups of people who have not had chickenpox as children or been vaccinated against it, i.e. whose blood does not contain any antibodies, to undergo a catch-up vaccination:

• Children and young people aged 9 to 17 years
• women who wish to have children
• People with severe neurodermatitis
• Patients about to undergo organ transplantation or therapy with drugs that suppress the immune system (e.g. cancer patients)
• Members of certain professional groups, for example health workers in the maternity, children’s or cancer wards as well as carers of patients with immunodeficiency or employees in community facilities

If unvaccinated people become infected through contact with infected people, the outbreak of the disease can be counteracted by a so-called incubation vaccination. However, this must be administered within five days of the suspected infection so that it can develop its preventive effect early enough. This is also possible in the case of an illness during pregnancy. Matched active ingredients are used.

Combination with MMR vaccination

For several years, the varicella vaccine has also been available as a quadruple vaccine MMR-V in combination with the serum against measles, mumps and rubella (MMR). You can find out more about the MMR vaccination in our article on the subject.

Vaccination critics recommend later chickenpox vaccination

In view of the fact that most complications associated with chickenpox do not appear until adulthood and that the disease in children is mostly benign, some parents refrain from vaccination against chickenpox in infancy. If the child does not get chickenpox until adolescence and therefore does not develop immunity, it is still possible to catch up on the vaccination and thus protect it from a problematic disease.

Disadvantages of the high vaccination rate against chickenpox

Vaccination critics claim that the chickenpox vaccination does not effectively prevent the disease, but merely postpones the infection into adulthood. In contrast to a previous chickenpox infection, the vaccination does not offer lifelong immunity. An infection at an advanced age is therefore not unlikely and is often much more serious than in childhood.

There is also a kind of long-term side effect from the early chickenpox vaccination. Nest protection is not as effective in newborns born to vaccinated mothers as in mothers with a history of chickenpox. The antibody level of vaccinated mothers is not sufficient to protect the infant from infection long enough until it no longer belongs to one of the special risk groups. In order to avoid infection, many parents decide to vaccinate their child very early. With increasing vaccination rates, acute chickenpox infections decrease in the short term, but in the long term their positive side effects on the immune system primarily decrease.

Who shouldn’t get the chickenpox vaccine?

If you decide to have your child or yourself vaccinated against chickenpox, you should be aware that vaccination should not be given under certain circumstances. Reasons for postponing or forgoing vaccination may be:

• Acute infections: If the person to be vaccinated has a severe, feverish infection, the chickenpox vaccination should be postponed until the vaccinated person is completely healthy again. A simple cold or slight infections that do not require any special medical treatment, on the other hand, do not usually represent an obstacle.
• Previous, severe vaccination reactions: If the person to be vaccinated has already shown very severe, physical reactions after an injection of the same vaccine, which went beyond the normal extent of vaccination reactions, this serum should not be used again. Examples of reactions that fit this description include a high, persistent fever, fainting, seizures, or acute shortness of breath.
• Allergies to ingredients: If allergies to individual ingredients of the vaccine serum are known, such as gelatine or the antibiotic neomycin, an alternative vaccine should be used.
• Pregnancy: Since the vaccine against chickenpox is a live vaccine that contains a weakened but reproducible form of the virus, it should not be vaccinated if you are pregnant. If you suspect that you are pregnant, you should tell your doctor before you get the chickenpox vaccination.
• Immunodeficiency: In the case of a congenital or acquired immune deficiency, vaccination with a live vaccine is generally not permitted. Taking medication that regulates the function of the immune system, for example during cancer or tumor treatment, also speaks against vaccination against chickenpox.

It is important that you have a detailed consultation with the treating doctor before a vaccination, in which he can inform you about all possible risks of a vaccination and possibly recommend alternative options.

Possible side effects of the chickenpox vaccine

As with any vaccination, slight reactions at the injection site can also occur with the vaccination against varicella. Redness, swelling and temporary pain are very common side effects. General feelings of illness such as headaches and body aches, a slight fever, exhaustion or gastrointestinal complaints often occur in connection with the vaccination. In rare cases, pneumonia can develop after the chickenpox vaccination.

One to four weeks after the chickenpox vaccination, a so-called vaccination disease, in this case vaccine chickenpox, can develop. These show the same symptoms as the actual disease, albeit mostly in a weaker form. However, the chickenpox vaccine can also be contagious, which is why contact with people in risk groups, such as immune disorders or pregnant women, should be avoided for about six weeks after vaccination.

Because the vaccine is a live vaccine, parts of the vaccine virus can get stuck in the body, just like after chickenpox. Sooner or later, this can lead to reactivation of the virus, which can then trigger shingles.