Chicken Pox Immunity
I am a mother with a 14 year old daughter. When I was 4 yrs old, I had a moderate case of chickenpox. When I became pregnant with my daughter, my 8 yr old son contracted a very mild case of the chickenpox. So mild, the doctor said he would likely catch them again. He is 23 now and never did. I was about 20 weeks pregnant when this happened. My daughter is now 14 and has never contracted chickenpox even after repeated exposure. Is it possible she is immune, because I was immune at the time of the exposure in my pregnancy? State law does not require her to get the varicella vaccine, which would be 2 doses. Should she be vaccinated anyway?
“Is she Immune?”
Dear “Is she Immune”,
Children who were exposed to the varicella-zoster virus in utero or before they were born can develop Varicella (Chicken Pox) without knowing it. This could be the case with your daughter. Another possibility is that your daughter may have had Chicken Pox as a young child but did not develop the classic symptoms. Many people report never having Chicken Pox, when they actually did, but never knew it. (1)
Since your daughter has had repeated exposure to Chicken Pox and never seemed to develop the disease there is a chance that she is immune. The only way to be sure is to have her tested. Your daughter’s Pediatrician can order serology testing for Varicella titers. This involves giving a blood sample which will tell if she is immune or not.
If your daughter is not immune, there is a concern that she may develop the disease when she is older. This is not a desirable situation. Chicken Pox is a contagious viral infection that causes mild symptoms in young children, and potentially serious consequences for someone older. The symptoms of Chicken Pox in a young child include a sore throat, and skin lesions which are pruritic or itchy. The symptoms become more severe and the risk of complications is greater as a child gets older. These complications may include encephalitis, ataxia, thrombocytopenia, seizures, arthritis, hepatitis, meningitis, and glomerulonephritis.
There is an additional concern if the non-immune child is a female. If a female doesn’t contract Chicken Pox before her child-bearing years there is a concern that she may develop the disease when she is pregnant. If a pregnant woman develops Chicken Pox her newborn has the risk of developing Fetal Varicella Syndrome which results in limb deformities and scarring of the skin. (1) If a pregnant woman develops chicken pox five days before or 2 days after delivery the newborn infant is at the risk of developing severe Varicella with fatality rates as high as 30%.(2)
If the serology testing reports that your daughter is not immune, it would be a good idea to have her vaccinated now. There are many parents who wish to wait for their child to develop Chicken Pox naturally instead of getting vaccinated. This is not a viable option for your daughter because at this point in her life, there is not a good chance that she will contract Chicken Pox naturally. The reason for this is because the incidence of live Chicken Pox in the community is low. Most children are vaccinated against the disease and there is less opportunity to catch it naturally.
There have been reports of a 79% decrease in cases of Chicken Pox disease since the introduction of the Varicella vaccine in 1995. (3) In addition, Varicella occurs in 90% of U.S. children before age 10 years. (4) Since your daughter’s 14, there is a very low chance that she will be exposed to other children with the Chicken Pox. By vaccinating her now you will protect her and her future children from potential complications.
(1)Brunell, P. Varicella. Changing Epidemiology and Parents’ Perceptions. In Infectious Disease in Children. 2002. April; S (3-14).
(2)Committee on Infectious Diseases. Varicella-Zoster Infections. In: Peter G, ed. 1997 Red Book: Report of the Committee on Infectious Diseases. 24th ed. Elk Grove Village, IL: American Academy of Pediatrics1997:573-574.
(3)Stephenson M. Varicella zoster virus vaccine making a big dent in case rates. Infectious Diseases in Children. 2006;June: 31.
(4)Pang, M. Spot the Rash. Infecious Diseases in Children. 2006;March:90.
Lisa Kelly R.N., P.N.P., C.
Certified Pediatric Nurse Practitioner
Pediatric Advice about Disease Prevention