Varicella (Chickenpox) Vaccine Archive
-- Superseded Information -- HISTORICAL USE ONLY -- See Current Information --Update on Supply of Merck & Co., Inc. Vaccines
November 16, 2007 -- The Centers for Disease Control and Prevention (CDC) maintains a webpage with the latest national information about vaccine supplies and provides guidance to healthcare providers who are facing vaccine shortages or delays at: http://www.cdc.gov/vaccines/vac-gen/shortages/default.htm.
Varicella
Merck is continuing to experience a vaccine supply interruption and shipping delays of 6 to 8 weeks for varicella orders. While there is no change in the routine recommendation, provision of Temporary Medical Exemptions may still be necessary.
Please be assured that the Florida Vaccines for Children (VFC) Program has sufficient Haemophilus influenzae type B, Varicella, and Hepatitis A vaccine available. The bureau will provide vaccine supply updates as indicated.
Update on Supply of Vaccines Containing Varicella-Zoster Virus
October 29, 2007 -- We are continuing to experience extended delivery timelines for vaccines containing varicella-zoster virus. Shipments of varicella vaccines are anticipated to be delivered within 30 to 35 business days, or six to seven calendar weeks. However, there is no change in the routine recommendation for vaccines containing varicella-zoster virus. Providers should plan on recalling any children or adolescents who have been given temporary medical exemptions as soon as the vaccine supply is sufficient.
Questions regarding the supply of these Merck products should be addressed to Merck's National Service Center at (800) 637-2590. Updates on vaccine shortages and delays are available from the Centers for Disease Control and Prevention (CDC) at: http://www.cdc.gov/vaccines/vac-gen/shortages/default.htm. We will continue to provide updates about the supply of varicella-zoster-containing vaccines as new information becomes available.
For further information regarding adult immunization recommendations, prevention of hepatitis A after exposure, or the supply of vaccines containing varicella-zoster virus, please contact the Bureau of Immunization at (850) 245-4342.
Varicella Recommendations
The Centers for Disease Control and Prevention (CDC) published Prevention of Varicella: Recommendations of the Advisory Committee on Immunization Practices (ACIP) in the June 22, 2007 / 56(RR04);1-40 Morbidity and Mortality Weekly Report (MMWR) Recommendations and Reports. These recommendations were available online previous to this publication, but were considered provisional until now. The new recommendations include:
- Implementation of a routine 2-dose varicella vaccination program for children, with the first dose administered at age 12-15 months and the second dose at age 4-6 years;
- A second dose catch-up varicella vaccination for children, adolescents, and adults who previously had received 1 dose;
- Routine vaccination of all healthy persons aged >=13 years without evidence of immunity;
- Prenatal assessment and postpartum vaccination;
- Expanding the use of the varicella vaccine for HIV-infected children with age-specific CD4+T lymphocyte percentages of 15%-24% and adolescents and adults with CD4+T lymphocyte counts >=200 cells/microliter; and
- Establishing middle school, high school, and college entry vaccination requirements. ACIP also approved criteria for evidence of immunity to varicella.
Note: The PDF version ( linked below) includes a free CDC-sponsored continuing-education activity that can be completed online or submitted by U.S. mail for CME, CEU, or CNE credit. To access a web-text (HTML) version of the recommendations, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5604a1.htm.
Provisional Recommendations for Varicella Vaccine 2nd Dose
The Advisory Committee for Immunization Practices (ACIP) updated the provisional recommendations for the prevention of varicella on August 3, 2006. The provisional recommendations were first posted in November 2005. In June 2005 and June 2006, the ACIP made policy changes for use of live, attenuated varicella-containing vaccines for prevention of varicella.
Changes include routine two dose varicella vaccination of children and second dose catch-up varicella vaccination for children, adolescents and adults who previously had received only one dose. The ACIP also expanded recommendations for varicella-containing vaccines to promote wider use of the vaccine for adolescents, adults, and HIV-infected children and approved new criteria for evidence of immunity to varicella.
Provisional recommendations for prevention of varicella include but are not limited to:
- All children <13 years of age should be administered routinely two doses of varicella with the first dose administered at 12-15 months of age and the second dose at 4-6 years of age (i.e., before a child enters kindergarten or first grade). The second dose can be administered at an earlier age, provided the interval between the first and second dose is at least 3 months. However, if the second dose is administered at least 28 days following the first dose, the second dose does not need to be repeated.
- A second dose catch-up varicella vaccination is recommended for children, adolescents, and adults who previously had received one dose to improve individual protection against varicella and for more rapid impact on school outbreaks. Catch-up vaccination can be implemented during routine healthcare provider visits and through school and college entry requirements. Catch-up second dose can be administered at any interval longer than 3 months after the first dose.
The ACIP revised criteria for evidence of immunity to varicella is detailed in the new provisional recommendations. The criteria for proof of immunity includes any of the following: documentation of age-appropriate vaccination; laboratory evidence of immunity; laboratory confirmation of disease; born in the U.S. before 1980; healthcare provider diagnosis of varicella or healthcare provider verification of history of varicella disease; or history of herpes zoster based on healthcare provider diagnosis.
Please note: current school immunization requirements, as referenced in Chapter 64D F.A.C., allows schools to accept parental history of disease for entry to childcare facilities and schools in Florida. Changes to update school requirements regarding proof of varicella immunity will be considered in the coming months.
Second dose of varicella is not required for entry to school or child care at this time.
Measles, mumps, rubella and varicella (MMRV) vaccine is licensed and indicated for simultaneous vaccination against measles, mumps, rubella, and varicella among children 12 months through 12 years of age. For routine immunization, use of licensed combination vaccines, such as MMRV vaccine, is preferred over separate injection of equivalent component vaccines.
