By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

VACCINE CAN PROTECT TEACHER WHO HAS NEVER HAD CHICKENPOX

Question: I am an elementary school teacher, and I dread seeing spring come because the children blossom with chickenpox. I thought there was a vaccine now to prevent this illness. I am worried that I may get chickenpox. I don’t remember having them as a child and my mother doesn’t either. What should I do?

Answer: First of all, your observation about chickenpox coming in the spring is correct. The peak incidence of chickenpox is between January and May. And yes, there is a vaccine for chickenpox now. But chickenpox is still around.

Chickenpox is a viral illness caused by the herpes varicella virus. It is spread through direct contact, coughing and sneezing, and can be transmitted during pregnancy to the fetus. There is an 11 to 21 day incubation period after exposure. Symptoms of illness such as fever, fatigue and headache precede the rash. The rash typically starts on the trunk and spreads to the face.

Initially the “spots” look like little flea bites, then progress to having a clear, blister-like head, then a cloudy blister on a red base. The lesions come in crops -- many new lesions appear every day for several days before they start to crust over. An infected person is contagious for a few days before the rash starts until all of the lesions have crusted over.

Even though you’ve never had chickenpox, you can still take measures to prevent catching it from your infected pupils. This involves the vaccine I mentioned earlier. We’ve had it since since the late 1990s.

The Centers for Disease Control and Prevention recommend this vaccine for three groups. First, it is recommended for all children between 12 and 18 months of age who have not had chickenpox; second, for children between 19 months and their 13th birthday who have not had chickenpox; and third, for anyone 13 and older who has not had chickenpox.

Initially children were given just one shot and adults two, but now the recommendation is for two shots for everyone. For children, the first shot is given after age 1 and the second is given about age 5. For adults, the shots should be four to eight weeks apart.

This vaccine can be given to anyone who is not pregnant, does not have active tuberculosis, is not seriously ill, does not have an immunosuppressive illness or is not around someone who is immunosuppressed. Under-immunized and un-immunized individuals can get the vaccine after exposure to chickenpox to prevent an outbreak as well.

About 75 percent of U.S. adults without a known history of chickenpox are nevertheless immune to this disease. While there is a good chance that you are in this group, I’d still recommend that you speak with your doctor about getting the chickenpox vaccine. This is because chickenpox in an older adult can lead to serious complications, including death. Your doctor will be able to determine if there are any specific reasons why you should not be vaccinated against chickenpox. Otherwise, since you are in an occupation with a high risk for exposure, I feel that vaccination against chickenpox probably would serve you well.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.