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At least 3-4 times a month I get asked about chickenpox, the vaccine, and its protection against and relationship to shingles.  Most people have heard about shingles, may even know someone who has had it, seem to know there is some relationship to chickenpox, but don’t fully understand what that relationship is. For that reason, I thought that this would be a good topic to discuss and I could give a quick chickenpox-shingles 101 lesson.

 Chickenpox is a member of the herpes virus family.  Humans are the only source of infection for this highly contagious virus.  It is spread quite easily from person to person by direct contact, airborne droplets and respiratory secretions (that means sneezing and coughing) and direct contact with vesicular lesions from both chickenpox and zoster (or shingles) lesions.  Once you become infected with chickenpox, the varicella-zoster virus never leaves your body, but becomes dormant in your nerve root endings.  Reactivation of the virus results in zoster, or “shingles”.

 As chickenpox is characterized by an itchy, vesicular rash all over the body, shingles consists of grouped vesicles in 1 to 3 small areas that are innervated by the nerve root ending that the virus reactivated from (these are called dermatomes).  Shingles is usually quite painful and can continue to be uncomfortable even after all of the lesions have cleared up.

As mentioned earlier, both the lesions from chickenpox and shingles are highly contagious.  Persons with the disease are contagious from 1-2 days before the vesicles are visible and remain contagious until they are all crusted over.  Both chickenpox (varicella) and shingles (zoster) cause chickenpox in susceptible children and adults who do not have immunity, either by disease or immunization.  Remember, you can’t get shingles without first having chickenpox or the vaccine.

Most parents worry about their kids getting shingles or chickenpox from a family member who has shingles.  Most of the time it’s a grandparent.  Here’s the good news, most toddlers and children have received their chickenpox vaccine at 12 months of age and a second dose between 4-6 years, and therefore are protected and free to be around that family member.  If, however, they are under one year of age or have not received their vaccine, I would recommend avoiding exposure, as they are definitely susceptible to contracting chickenpox.

Does the vaccine protect you from getting shingles?  No, but data has shown that the severity of shingles seems to be milder among vaccinated children compared to children that contracted chickenpox the old fashioned way.

How effective is the vaccine?  The efficacy of 1 dose is 70-90% against contracting chickenpox and 95% effective against severe disease. Those are some pretty good numbers!

How long does the vaccine keep you protected?  The vaccine has only been licensed in the United States since 1995, but current studies from Japan indicate persistence of immunity for at least 20 years.

Finally, does my child really need this vaccine? Yes. Most parents remember getting chickenpox as children. They remember the itching, maybe a fever and some achiness, oatmeal baths, calamine lotion, and missing a week of school. For the most part that is what chickenpox is all about. I too remember all of the above, and I also know that I was single-handedly responsible for the majority of my kindergarten class contracting the disease. However, not all cases of chickenpox are harmless. Complications from chickenpox can cause hospitalization and in rare cases death. I saw this first hand during my residency. The 7-year-old boy in the ICU with severe pneumonia and respiratory distress syndrome. He was on a ventilator with multiple chest tubes when I began my rotation and he was still the same, one month later, when I finished. Then the teenage girl with half of the skin on her back removed from the extreme staph skin infection complicating her chickenpox. Finally, the little baby who just turned 18 months, and was in the crusting over phase of his chickenpox when he stopped breathing and died. On autopsy it was discovered that he had a chickenpox lesion in the area of his brain that controls breathing. None of these kids were fortunate enough to have had the chickenpox vaccine because it was not yet available.

Now the good news, since the introduction of the vaccine, the overall rate of hospitalization from chickenpox has declined by 90% and there have been few fatal cases. As with many diseases today we forget how bad they can be. Let’s not forget and instead be thankful that our kids are fortunate to live in an era where they can be protected through vaccination.

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Showing 26 comments
  • Naomi Cruz
    Reply

    I have a question that seems to never be addressed in articles related to shingles. In my practice of 28 years as a school nurse, I have seen students contract shingles “coincidentally” from a teacher who had shingles. Also I have seen cases when a grandmother who cared for an infant contracted shingles after the grandchild received the varicella vaccine. Since the vaccine is a live virus this makes sense however this never seems to be documented. I really don’t think it’s coincidental because there also seems to be a either, a person with shiingles passing the virus or a year old passing the virus to a grandparent. The CDC states neither can happen, but what I see in life, says it can. I would appreciate any insight. Thank you.

    • levans
      Reply

      Hi Naomi, thanks for your question, and I apologize for the delay in response. We ran this question by one of our pediatric infectious disease experts, and this was his response.

      “If exposure to varicella or vaccine can induce zoster, it must be very rare since it is not well documented in the literature. This is not the first time I have heard of this potential association. It is plausible that the immune response to exposure might disrupt the latent state of varicella and induce zoster.”

      I hope this answers your question, and again, thank you for the interest in our blog.

      • Amanda Lee Smith
        Reply

        My 2 year old son, who has never had chicken pox, was diagnosed with shingles this week. He had the vaccine at 12 months. Again – HE’S NEVER HAD CHICKEN POX. But he’s got shingles. It happens.

    • Melissa
      Reply

      Of course it’s not documented. People would have to report it to the VAERS themselves or convince their doctor to. Then, if it didn’t happen 15 seconds after the shot was administered right there in the doctor’s office, it’s impossible to prove to Pharma that it’s linked. Yes, what we see in the real world is real. What we read about in controlled studies is just that. Controlled. Once it’s out here in the world, it is no longer under control.

      • Morgan Mills
        Reply

        I can vouch. My 4yo (who was vaccinated and also received a booster this past October) was recently diagnosed with shingles. Poor girl developed shingles, but because “she was only 4 and had been vaccinated” the doctor we saw denied that it was shingles and instead diagnosed her with contact dermatitis :/ (I don’t know what contact dermatitis begins faintly and flares up a week later, but she adamantly denied the possibility of shingles because of my daughter’s age). Had to see a dermatologist for correct diagnosis; Derm said that it is rare, but not unheard of for vaccinated children to get shingles. The youngest she diagnosed was 2.

    • Sarah
      Reply

      Remember, you can’t get shingles without first having chickenpox or the vaccine? Wrong. My 17year old ,though never had chicken pox,he had the required vaccinations for the chicken pox when he was younger.It took two different doctors from the hospital to diagnosed him with having shingles after his regular primary physician didn’t know what it was.

  • Deanna Boone
    Reply

    My 8 year old has just been diagnosed with shingles, she has never had chickenpox, but she did have the chickenpox vaccine.

    • levans
      Reply

      We ran this question by one of our pediatric infectious disease experts, and this was his response.

      If exposure to varicella or vaccine can induce zoster, it must be very rare since it is not well documented in the literature. This is not the first time I have heard of this potential association. It is plausible that the immune response to exposure might disrupt the latent state of varicella and induce zoster.

    • Lori
      Reply

      When I was 3 or 4yo in 1964 or ’65, I had shingles. My parents swore I never had chicken pox. Someone suggested I may have had chn pox while in my mother’s womb. The vaccine wasn’t around back then. It’s also possible my parents didn’t notice me having it as a baby.

  • Debra Walker
    Reply

    My siblings had chicken pox (5) and I didn’t get it. My kids had it too. Do I need the shingles vaccine?

    • levans
      Reply

      Hi Debra, you would need to consult your physician to make a decision about the shingles vaccine.

  • Emily Misner
    Reply

    I currently have shingles and had never had the shingles vaccine, my 4 yo grand daughter had her first Chicken Pox vaccine 2 days ago. She is supposed to come for a visit tomorrow and I don’t know if I am contagious to her? I’ve tried looking up the answer and came up empty. Please, My doctor said she could come but her parents are still concerned. My breakout is completely in my hair.

    • levans
      Reply

      Hi Emily, sorry for the delayed response, I would follow the advice of your doctor, as we are unable to give medical advice here. Hope you were able to visit your granddaughter.

      • Lisa
        Reply

        Mine is in my head.crazy few people get it there. How long did it last

  • Kelly
    Reply

    I have recently had shingles and I am worried my kids would get chicken pox since they haven’t had the vaccine? Also I had a friend that she thought her daughter had shingles but her daughter had never had chicken pox or had the vaccine could that have been possible?

    • levans
      Reply

      Hi Kelly, thank you for your question regarding shingles/chicken pox. We are unable to give medical advice here, the best thing to do is contact your physician or your child’s pediatrician for expert medical advice.

  • Marie Filer
    Reply

    When our 57 year old daughter was an infant between 6 to 9 months old, her pediatrician diagnosed her with shingles when he saw a rash near her naval and extending toward her left side. I never noticed a “fussy” time with her prior to this, and assumed it was a diaper irritation.
    Nothing was prescribed for her and it all healed.
    My question is regarding people never believing this to be true! Her younger siblings and classmates had chicken pox over the years, and to this date she has never contracted chickenpox. Even after caring for her own children when they were stricken while vacationing far from home. The pediatrician said she would never have chickenpox because she would be immune. So far he was right on.

  • Linda Allison
    Reply

    I’ve had chicken pox as a child. My granddaughter currently has chicken pox. Can I get shingles if exposed?

  • Lori LeClaire
    Reply

    When I was 3 or 4yo in 1964 or ’65, I had shingles. My parents swore I never had chicken pox. Someone suggested I may have had chn pox while in my mother’s womb. The vaccine wasn’t around back then. It’s also possible my parents didn’t notice me having it as a baby.

  • Shelly
    Reply

    I never had the chicken pox but had the vaccine in 1997. I spent the day with a friend of mine yesterday and today her husband was diagnosed with Shingles so I’m wondering about my risk. For myself and because work in a preschool with an infant center and need to know the likelihood of carrying anything there. I am also being tested for autoimmune

    • levans
      Reply

      The best thing to do is consult with your own primary care physician.

    • Dakoda smith
      Reply

      Help! This is urgent. My 21 month old was diagnosed with chicken pox 3 weeks ago. And he still has them BAD! nothing helps. He’s miserable. I’ve tried everything. He’s been to the ER twice. The first to be diagnosed and the second he had developed a type 2 infection on his back. They prescribed antibiotics and antibiotic cream. And that still didn’t help. They are everywhere! I am at the point to where I don’t know what to do! He’s constantly crying saying it hurts. But like ive said I’ve tried everything. I dont know what else to do……….

  • Melissa
    Reply

    My daughter is 3.5 and currently has shingles she hasn’t not had chicken pox but has has the first vaccine
    She has them on her face and they are very bad the chicken pox vaccine did not help her from getting this

    • levans
      Reply

      Please consult with your daughter’s pediatrician for medical advice.

  • J
    Reply

    My fiancé has shingles, I’m in my first trimester of pregnancy . I had one shot when I was about 14 for the vacinantion. I am 29 now. What is your advice on my case?

  • Ashe
    Reply

    My sons were children many years before the chicken pox vaccine was introduced. They were being tandem fed (that means they were both getting my breastmilk and my immunity as I had had chicken pox as a child) when the chicken pox went around the area, and both got a few spots, but were not ‘sick’ as such. 3 years later (the cycle of chicken pox seems to be about 3 years) they both got a few more spots….hence they both got chicken pox twice!
    (As an aside; my brother got mumps twice….long before that vaccine was intorduced)

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