The new state law mandates that children entering kindergarten for the first time after July 1 must have received one dose of varicella (chickenpox) vaccine on or after their first birthday or provide proof of having had the disease.

In addition, all children two years or older must have had the chickenpox shot on or after their first birthday or provide proof of having had the disease if, on July 1 or later, they enter for the first time a child care facility or pre-kindergarten program, such as nursery school, preschool, early childhood or federally funded Head Start center, operated by a school or school district.

Illinois is the 35th state to enact a school or child care requirement.

The Department began a two-year effort to consider instituting a chickenpox vaccination requirement in 2000 that included contradictory recommendations from the state's Immunization Advisory Committee and the State Board of Health, and public hearings conducted throughout the state.

Dr. Lumpkin decided in the fall of 2001 to seek approval to require the vaccination and the proposed rules were published in late 2001. After public comment was gathered and responded to, the Illinois General Assembly's Joint Committee on Administrative Rules voted no objection to the recommendation in April 2002.

For Illinois schoolchildren, chickenpox is the ninth disease for which immunization is required. The others are diphtheria, hepatitis B, measles, mumps, pertussis (whooping cough), polio, rubella and tetanus.

Chickenpox, or varicella, is generally a mild disease, but the U.S. Center for Disease Control and Prevention (CDC) reports that it kills more children and adolescents than all other diseases combined for which vaccination is routinely recommended.

CDC estimates that about 100 persons die, mostly young children, and 9,300 hospitalizations occur each year from varicella-related complications.

In Illinois, 10,653 persons had varicella in 2001, down from 24,798 in 1995 when the vaccine was first licensed for the use in the United States. There were 51 deaths from chickenpox in Illinois in the 1990s, including five in 1999, the most recent year for which disease death statistics are available, and 416 hospitalizations for the disease in 2000.

Chickenpox is highly contagious and is spread from person to person by direct contact or through the air. The disease, which is caused by varicella zoster virus, starts as an itchy rash that progresses to blisters that dry and scab in two to four days. In children, rash may be the first sign of illness, sometimes coupled with fever and general malaise.

Chickenpox is contagious one to two days before the rash appears and until all blisters have formed scabs. It develops within 10 to 21 days after contact with an infected person.

State law does provide exemptions from the immunization requirements for religious and medical reasons.

For an exemption on religious grounds, the parent or legal guardian must submit a written and signed statement to the local school authority detailing the religious belief that conflicts with immunizations. A medical exemption must be requested by a licensed physician indicating the medical condition that precludes the child from receiving the required immunization(s).

The Department's federally funded Vaccines for Children program provides the chickenpox vaccine, through physicians and local health departments, to Medicaid-eligible persons, persons who have no health insurance, Native Americans or Alaskan Natives. Persons who have insurance, but do not have coverage for immunizations and who meet income eligibility requirements, can receive the vaccine at a federally qualified health center or rural health center.