Varicella Vaccination Guidelines
Primary Vaccination Schedule
- The American Academy of Pediatrics recommends that all healthy infants receive their first dose of varicella vaccine at 12-15 months of age, followed by a second dose at 4-6 years of age, with a minimum interval of 3 months between doses 1, 2
- The varicella vaccine is approved for use starting at 12 months of age and should be administered routinely between 12-15 months 1, 2
Dosing Intervals and Administration
- The minimum interval between doses is 3 months for children 12 months through 12 years, with an absolute minimum acceptable interval of 28 days 1, 2
- For adolescents and adults ≥13 years, the minimum interval between doses is 28 days 1, 2
- The vaccine should be administered subcutaneously in a 0.5 mL dose 1, 3
Concomitant Vaccine Administration
- The varicella vaccine can be safely administered simultaneously with other routine childhood vaccines without compromising immunogenicity 3
- Concomitant administration with DTaP, Hib, and hepatitis B vaccines produces comparable seroconversion rates to individual administration 3
Immunogenicity and Efficacy
- Two doses of varicella vaccine provide 98% vaccine efficacy compared to 94% for a single dose 2
- Recipients of 2 doses are 3.3-fold less likely to experience breakthrough varicella 2
- After two doses, >99% of children achieve protective antibody levels 2
Contraindications and Precautions
- The vaccine is contraindicated in individuals with evidence of immunity to varicella-zoster virus, immunocompromised children, pregnant women, and those with a severe allergic reaction to previous dose or vaccine component 1
Cost-Effectiveness
- Both 1-dose and 2-dose programs are cost-saving at the societal level 1
- The incremental cost for the second dose is $96,000 per quality-adjusted life-year saved 1