Chickenpox vaccine

Also called varicella vaccine

Key points about chickenpox vaccine

  • Chickenpox vaccine protects against infection from the varicella zoster virus, which causes chickenpox infection.
  • The chickenpox vaccine is also called Varivax®.
  • Find out about the vaccine and possible side effects.
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Chickenpox vaccine protects against infection from the varicella zoster virus, which causes chickenpox infection. The virus is easily spread by sneezing and coughing, or by contact with weeping chickenpox blisters. You can even catch the chickenpox virus from touching clothing or other objects that have fluid from the blister on them.

Note: There is another varicella vaccine called Zostavax®. This is to protect against shingles and is not given to children.

The chickenpox vaccine is a live vaccine which is made using chickenpox viruses that have been weakened (or attenuated), before being included in the vaccine. After vaccination, the weakened vaccine viruses replicate (grow) inside you. This means a very small dose of virus is given to stimulate a response by your immune system.

Live attenuated vaccines don't usually cause disease in vaccinated people who have a healthy immune system. When a live attenuated vaccine does cause any illness, it is usually milder than if you had caught the disease. Live attenuated vaccines given by injection are generally effective after one dose.

Chickenpox – Disease and Vaccine, New Zealand

(The Immunisation Advisory Centre, NZ)

In most people, chickenpox is a mild disease that doesn't cause any lasting problems. Around 1 in 20 healthy children develop a bacterial skin infection from chickenpox, which needs antibiotic medicine. Untreated bacterial skin infections can lead to bacterial infection in other parts of your body, including pneumonia and blood stream infection (septicaemia). Other complications of chickenpox are rare and include encephalitis (brain inflammation) and inflammation of your joints, kidneys and liver. 

Chickenpox tends to be more severe in adolescents and adults, pregnant women and their unborn babies and people of any age with poorly functioning immune systems. Read more about chickenpox.

Pregnant women

Chickenpox during pregnancy can spread to your baby. The highest risk is during the first 20 weeks of pregnancy. Up to 2 in 100 infants exposed to chickenpox before birth are born with congenital varicella syndrome and may have skin scarring, eye, limb and brain abnormalities, developmental delay and a poor outcome. Up to 30 in 100 newborn babies with chickenpox develop severe disease that can result in death. 

Pregnant women should not be given the chickenpox vaccine. The vaccine’s safety in the unborn baby has not yet been demonstrated, although no harmful effects have been described following inadvertent administration to pregnant women.

When you get vaccinated, you should avoid getting pregnant for at least 1 month afterwards. If you're planning a pregnancy, check in early with your midwife or doctor to see whether you need to be vaccinated against chickenpox.

Chickenpox vaccination is recommended and funded in New Zealand for the following groups:

  • children turning 15 months of age
  • children turning 11 years of age who have never been infected with or previously vaccinated against chickenpox.

The vaccine is funded for certain high-risk individuals and/or their close contacts, regardless of age. People with a weakened immune system are at high risk, but may not be able to have the vaccination themselves, so it's recommended that close contacts of these people be vaccinated. Discuss this with your GP. 

Chickenpox vaccination is also recommended, but not funded, for:

  • teenagers and adults who have never been infected with or vaccinated against chickenpox
  • women who are planning a pregnancy and have never been infected with or vaccinated against chickenpox, such as those born and raised in tropical countries
  • people who are not immune to chickenpox and who are working in professions where they come into contact with young children
  • parents who have not had chickenpox. 

Chickenpox vaccine is a live vaccine. This means that it can cause chickenpox, although it is usually milder, and it should not be used for certain groups of people who have reduced infection-fighting ability (immunity), such as if you:

  • are pregnant (pregnancy should be avoided for 4 weeks following vaccination)
  • are taking high-dose oral steroids such as prednisone or dexamethasone
  • are getting chemotherapy or radiation
  • have a condition that reduces your immunity such as cancer or HIV
  • have active untreated TB (tuberculosis)
  • have had another live vaccine (eg, MMR, BCG) within the past 4 weeks.

A single chickenpox vaccine dose provides about 99% protection against severe disease and 80% protection against chickenpox infection of any severity. It is still possible to get chickenpox after having the vaccine, but the infection is usually mild.  

The chickenpox vaccine is given as an intramuscular injection (injected into the muscle either in your thigh or upper arm). It is usually given as 1 dose, but 2 doses may be recommended for some people.

The chickenpox vaccine can be administered with some other vaccines, including MMR, at different injection sites. If the chickenpox vaccine is not given at the same visit as another live injectable vaccine such as MMR, they should be separated by 4 weeks or more.

Like all medicines vaccines can cause side effects, although not everyone gets them. 

Side effects What should I do?
  • Pain, swelling or redness around the injection site (hard and sore to touch)
  • This is quite common after having the vaccination.
  • It usually starts a few hours after getting the injection and settles within a few days.
  • Place a cold, wet cloth or ice pack where the injection was given. Leave it on for a short time. 
  • Do not rub the injection site.
  • Tell your doctor if troublesome.

Read more: After your immunisation.(external link) 

  • Fever
  • This is quite common for the first 1 or 2 days after receiving the injection and usually settles within a few days.
  • Dress lightly, with a single layer of clothing.
  • Don't wrap your child in a blanket.
  • Keep the room cool and use a fan.
  • Drink plenty of fluids.
  • The routine use of paracetamol is not recommended following vaccinations, but may be used if your child is miserable or distressed.
  • Tell your doctor if the fever persists.

Read more: After your immunisation.(external link) 

  • Headache
  • Feeling unwell, tired or weak
  • These are quite common for the first 1 or 2 days after receiving the injection.
  • It usually settles within a few days.
  • Tell your doctor if troublesome.

Read more: After your immunisation.(external link) 

  • Mild rash
  • This rash is usually similar to chickenpox and can occur between 5–26 days after vaccination.
  • This can be contagious, although spread is rare, so keep any blisters covered and stay away from anyone at risk of severe disease, such as people with weakened immune systems, babies or pregnant women.
  • If you develop a rash after getting the vaccine and have contact with someone with a weakened immune system they should discuss this with their GP or specialist.     
Did you know that you can report a side effect to a medicine to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product(external link)

There are many different settings in which you can get a vaccination. These include medical or health centres, pharmacies, community-based clinics including marae-based clinics, mobile health clinics and mobile vaccination services.

Read more about who can give vaccinations and where to get vaccinated.

Vaccines on the National Immunisation Schedule(external link) are free. Other vaccines are funded only for people at particular risk of disease. You can choose to pay for vaccines that you are not eligible to receive for free.

The following links have more information on chickenpox vaccines:

Chickenpox (Varicella)(external link) The Immunisation Advisory Centre, NZ
Tips following immunisation(external link) Ministry of Health, NZ

Resources

5 questions to ask about your medications(external link) Health Quality and Safety Commission, NZ, 2019 English(external link), te reo Māori(external link)

References

  1. Varicella (chickenpox)(external link) Immunisation Handbook, NZ, 2020
  2. Varicella (chickenpox)(external link) The Immunisation Advisory Centre, NZ
  3. Varilrix(external link) The Immunisation Advisory Centre, NZ

Brochures

immunise against chickenpox moh nz

Immunise against chickenpox

Ministry of Health, NZ, 2017
Māori(external link)

infectious diseases brochure

Infectious diseases(external link)

Health Ed and Ministry of Health, NZ, 2022

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Credits: Sandra Ponen, Pharmacist, Healthify He Puna Waiora. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Angela Lambie, Pharmacist, Auckland

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