Varicella Exposure at Less Than 1 Year of Age

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Varicella Exposure at Less Than 1 Year of Age

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Question

Is varicella exposure an indication for a child less than 1 year of age to receive the varicella vaccine? If so, what would be the timeframe?

Response

from Anne A. Gershon, MD, 11/29/01
Under most circumstances, I would not recommend the varicella vaccine for children less than 1 year of age because there is very little experience in immunization of infants of this age group. I would not use varicella vaccine for a child less than 9 months of age because there is simply no experience with this vaccine in that age group.

Other reasons include:

Young infants with cell-mediated immunodeficiencies might not be diagnosed and they could react unfavorably to the vaccine.^[1]
Babies who have varicella (from vaccination) before 1 year of age are at increased risk of developing zoster in infancy and childhood.^[2]
Casual exposure to varicella-zoster virus often does not result in infection.

Should a child less than a year of age develop varicella, there is an increased risk of having a severe infection compared with an older child.^[3]However, an infant with varicella could be treated with acyclovir, which would avoid most complications in this age group.

References

Sharrar RG, LaRussa P, Galea S, et al. The postmarketing safety profile of varicella vaccine. Vaccine. 2000;19:916-923.
Gershon A. Chickenpox, Measles, and Mumps. 3rd ed. Philadelphia: W.B. Saunders Co; 2001.
Preblud S, Bregman DJ, Vernon LL. Deaths from varicella in infants. Ped Infect Dis. 1985;4:503-507.

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