Dear Dr Nina: Should I vaccinate my one-year-old against chicken pox?
Q. Should I vaccinate my one-year-old against chicken pox, and why isn’t it part of the official HSE vaccination programme?
Dr Nina replies: Chicken pox (varicella) causes an extensive intensely-itchy blistering rash that can occur all over the body. Infection occurs most commonly in young children but can occur at any age. It is highly contagious and is spread by secretions or by direct contact to the skin lesions themselves.
Most people have fever and flu-like illness for several days before the rash appears. The rash starts on the trunk and face and the spreads rapidly all over the body. It starts as small, red, slightly-raised spots, which then blister and finally crust.
A person will develop the illness about seven to 21 days after being exposed to the virus. It is contagious from 48 hours before the rash appears until 24 hours after the last spot has crusted (usually five to seven days). It is necessary to stay out of work, school or crèche for this time. The average amount of spots is 200, but in people with other illnesses or skin conditions there can be many more.
Vaccination is not routinely given here and there are no active plans to introduce it. The reason for this is not clear, but any mass vaccination campaign decision is usually made on a cost-benefit analysis. It is offered to healthcare workers, or those with lowered immunity that are considered at risk. Many parents are also now requesting and paying for the varicella vaccine. This is a live vaccine and two doses are required to maximise immunity.
It is usually given over 12 months of age as it is felt that the body responds best to live vaccines after this age. Most GPs are happy to arrange vaccination; the only barrier is the cost. This vaccine is not provided by the HSE, thus your doctor must order it in. Vaccination is not covered under the GP visit card for children under 6 either, so there is a charge for the vaccination and its administration.