Chickenpox is an infection caused by the varicella-zoster virus. Most cases are in children under age 15, but older children and adults can get it. It spreads very easily from one person to another.

The classic symptom of chickenpox is an uncomfortable, itchy rash. The rash turns into fluid-filled blisters and eventually into scabs. It usually shows up on the face, chest, and back and then spreads to the rest of the body. Other symptoms include

• Fever
• Headache
• Tiredness
• Loss of appetite

Chickenpox is usually mild and lasts 5 to 10 days. Calamine lotions and oatmeal baths can help with itching. Acetaminophen can treat the fever. Do not use aspirin for chickenpox; that combination can cause Reye syndrome.

Chickenpox can sometimes cause serious problems. Adults, babies, teenagers, pregnant women, and those with weak immune systems tend to get sicker from it. They may need to take antiviral medicines.

Once you catch chickenpox, the virus usually stays in your body. You probably will not get chickenpox again, but the virus can cause shingles in adults. A chickenpox vaccine can help prevent most cases of chickenpox, or make it less severe if you do get it.

Chickenpox is a highly contagious disease caused by the varicella-zoster virus (VZV). It can cause an itchy, blister-like rash among other symptoms. The rash first appears on the chest, back, and face, and then spreads over the entire body.

Chickenpox can be serious, especially during pregnancy, in babies, adolescents, adults, and people with weakened immune systems (lowered ability to fight germs and sickness).

The best way to prevent chickenpox is to get the chickenpox vaccine.

Chickenpox is a contagious disease caused by the varicella zoster virus. The virus spreads mainly by touching or breathing in the virus particles that come from chickenpox blisters, and possibly through tiny droplets from infected people that get into the air after they breathe or talk, for example. Symptoms of chickenpox include an itchy rash, fever, and tiredness. The disease can be serious – even fatal – especially for babies, adolescents, adults, pregnant women and people with a weakened immune system. The best protection against chickenpox is two doses of the chickenpox vaccine. Most people who get the vaccine will not get chickenpox. If a vaccinated person does get chickenpox, the symptoms are usually milder with fewer or no blisters (they may have just red spots) and mild or no fever.

Key Facts

• Chickenpox is a very contagious disease that is caused by varicella zoster virus.
• The classic symptom of chickenpox is a blister-like rash. You can have between 250 and 500 blisters all over your body.
• Before the vaccine was available, about 4 million people in the United States would get chickenpox each year.
• You can still get chickenpox if you have been vaccinated; however, the symptoms are usually milder, with fewer or no blisters (sometimes just red spots) and mild or no fever.
• CDC recommends two doses of chickenpox vaccine. If you previously got one dose, make sure to get a second one.

Chickenpox Transmission

It takes from 10 to 21 days after exposure to a person with chickenpox or shingles for someone to develop chickenpox. A person with chickenpox can spread the disease from 1 to 2 days before they get the rash, until all their chickenpox blisters have formed scabs.

Chickenpox Can Be Serious

Complications from chickenpox include infection of skin and soft tissues underneath, pneumonia, infection or inflammation of the brain, bleeding problems, and dehydration. Some people may be at high risk for complications, including infants, adolescents, adults, pregnant women, and those with a weakened immune system. Complications are not as common in otherwise healthy people who get chickenpox but can happen.

How It Spreads

The virus spreads mainly by touching or breathing in the virus particles that come from chickenpox blisters, and possibly through tiny droplets from infected people that get into the air after they breathe or talk, for example.

If You Get Chickenpox

Calamine lotion and colloidal oatmeal baths can help relieve an itchy chickenpox rash. Keep fingernails trimmed short to help prevent skin infections caused by scratching blisters. For fever, you can use non-aspirin medication, such as acetaminophen. Call a doctor if you’re at risk for severe chickenpox or you’re concerned about your symptoms.

The Link to Shingles

After you recover from chickenpox, the virus that causes this disease stays in your body. Later in life, the virus can reactive and cause shingles. If you have shingles, you can spread the virus to people who have never had chickenpox or never got the chickenpox vaccine. These people will develop chickenpox, not shingles.

Prevention Tips

• Chickenpox vaccine is very effective at preventing severe disease, complications, and death.
• Children, adolescents, and adults should get two doses of the chickenpox vaccine.
  • Children should get the first dose of chickenpox vaccine at 12 through 15 months old and a second dose at 4 through 6 years old.
  • People 13 years and older who have never had chickenpox or received chickenpox vaccine should get two doses at least 28 days apart. If you previously got one dose, make sure to get your second one.
• When you get vaccinated, you protect yourself and others in your community. This is especially important for people who cannot get vaccinated, such as those with a weakened immune system, babies less than 12 months old, or pregnant women.
• Some people should wait to get vaccinated or should not get vaccinated at all. This includes pregnant women and those with a severely weakened immune system.
• Talk to your doctor if you have questions about chickenpox or the chickenpox vaccine.

Chickenpox is a highly contagious disease caused by the varicella-zoster virus (VZV). The virus spreads easily from people with chickenpox to others who have never had the disease or never been vaccinated. The virus spreads mainly through close contact with someone who has chickenpox.

A person with chickenpox is considered contagious beginning 1 to 2 days before rash onset until all the chickenpox lesions have crusted (scabbed). Vaccinated people who get chickenpox may develop lesions that do not crust. These people are considered contagious until no new lesions have appeared for 24 hours.

The varicella-zoster virus also causes shingles. After chickenpox, the virus remains in the body (dormant). People get shingles when VZV reactivates in their bodies after they have already had chickenpox. People with shingles can spread VZV to people who have never had chickenpox or never received the chickenpox vaccine. This can happen through direct contact with fluid from shingles rash blisters or through breathing in virus particles that come from the blisters. If they get infected, they will develop chickenpox, not shingles.

It takes about 2 weeks (from 10 to 21 days) after exposure to a person with chickenpox or shingles for someone to develop chickenpox. If a vaccinated person gets the disease, they can still spread it to others. For most people, getting chickenpox once provides immunity for life. It is possible to get chickenpox more than once, but this is not common.

"Chickenpox Parties"—Don't Take the Chance

In the past, some parents participated in “chickenpox parties” to intentionally expose their unvaccinated children to a child with chickenpox in hopes that they would get the disease. CDC strongly recommends against hosting or participating in these events. Chickenpox can be serious and can lead to severe complications and death, even in healthy children. There is no way to tell in advance how severe your child’s symptoms will be. So it is not worth taking the chance of exposing your child to someone with the disease. The best way to protect infants and children against chickenpox is to get them vaccinated.

Anyone who has not had chickenpox or gotten the chickenpox vaccine can get the disease. Chickenpox illness usually lasts about 4 to 7 days.

The classic symptom of chickenpox is a rash that turns into itchy, fluid-filled blisters that eventually turn into scabs. The rash may first show up on the chest, back, and face, and then spread over the entire body, including inside the mouth, eyelids, or genital area. It usually takes about one week for all of the blisters to become scabs.

Other typical symptoms that may begin to appear one to two days before rash include:

• fever
• tiredness
• loss of appetite
• headache

Children usually miss 5 to 6 days of school or childcare due to chickenpox.

Chickenpox in Vaccinated People (Breakthrough Chickenpox)

Some people who have been vaccinated against chickenpox can still get the disease. However, they usually have milder symptoms with fewer or no blisters (or just red spots), a mild or no fever, and are sick for a shorter period of time than people who are not vaccinated. But some vaccinated people who get chickenpox may have disease similar to unvaccinated people.

People at Risk for Severe Chickenpox

Some people who get chickenpox may have more severe symptoms and may be at higher risk for complications.

Complications from chickenpox can occur, but they are not common in healthy people who get the disease.

People who may get a serious case of chickenpox and may be at high risk for complications include:

• Infants
• Adolescents
• Adults
• Pregnant women
• People with bodies that have a lowered ability to fight germs and sickness (weakened immune systems) because of illness or medications, for example,
  • People with HIV/AIDS or cancer
  • Patients who have had transplants, and
  • People on chemotherapy, immunosuppressive medications, or long-term use of steroids.

Serious complications from chickenpox include:

• Bacterial infections of the skin and soft tissues in children, including Group A streptococcal infections
• Infection of the lungs (pneumonia)
• Infection or swelling of the brain (encephalitis, cerebellar ataxia)
• Bleeding problems (hemorrhagic complications)
• Bloodstream infections (sepsis)
• Dehydration

Some people with serious complications from chickenpox can become so sick that they need to be hospitalized. Chickenpox can also cause death.

Deaths are very rare now due to the vaccine program. However, some deaths from chickenpox continue to occur in healthy, unvaccinated children and adults. In the past, many of the healthy adults who died from chickenpox contracted the disease from their unvaccinated children.

There are several things that you can do at home to help relieve chickenpox symptoms and prevent skin infections. Calamine lotion and a cool bath with added baking soda, uncooked oatmeal, or colloidal oatmeal may help relieve some of the itching. Try to keep fingernails trimmed short and minimize scratching to prevent the virus from spreading to others and to help prevent skin infections. If you do scratch a blister by accident, wash your hands with soap and water for at least 20 seconds.

Over-the-counter Medications

Do not use aspirin or aspirin-containing products to relieve fever from chickenpox. The use of aspirin in children with chickenpox has been associated with Reye’s syndrome, a severe disease that affects the liver and brain and can cause death. Instead, use non-aspirin medications, such as acetaminophen, to relieve fever from chickenpox. The American Academy of Pediatrics recommends avoiding treatment with ibuprofen if possible because it has been associated with life-threatening bacterial skin infections.

For people exposed to chickenpox or shingles, call a healthcare provider if the person:

• Has never had chickenpox and is not vaccinated with the chickenpox vaccine
• Is pregnant
• Has a lowered ability to fight germs and sickness (weakened immune system) caused by disease or medication; for example:
  • A person with HIV/AIDS or cancer,
  • A person who has had a transplant, or
  • A person on chemotherapy, immunosuppressive medications, or long-term use of steroids.

If you have symptoms, call your healthcare provider. Contacting a healthcare provider is especially important if the person:

1. Is at risk of serious complications from chickenpox because he or she:
   • Is less than 1 year old
   • Is older than 12 years of age
   • Has a weakened immune system
   • Is pregnant

OR

2. Develops any of the following symptoms:
   • Fever that lasts longer than 4 days
   • Fever that rises above 102°f (38.9°c)
   • Any areas of the rash or any part of the body becomes very red, warm, or tender, or begins leaking pus (thick, discolored fluid), as these symptoms may indicate a bacterial infection
   • Difficulty waking up or confused behavior
   • Difficulty walking
   • Stiff neck
   • Frequent vomiting
   • Difficulty breathing
   • Severe cough
   • Severe abdominal pain
   • Rash with bleeding or bruising (hemorrhagic rash)

Your healthcare provider can advise you on treatment options. Antiviral medications are recommended for people with chickenpox that are more likely to develop serious illness, including:

• Otherwise healthy people older than 12 years of age
• People with chronic skin or lung disease
• People receiving long-term salicylate therapy or steroid therapy
• Pregnant women
• People with a weakened immune system

There are antiviral medications licensed for treatment of chickenpox. The medication works best if it is given as early as possible, preferably within the first 24 hours after the rash starts.

The best way to prevent chickenpox is to get the chickenpox vaccine. Everyone—including children, adolescents, and adults—should get two doses of chickenpox vaccine if they have never had chickenpox or were never vaccinated.

Chickenpox vaccine is very safe and effective at preventing the disease. Most people who get the vaccine will not get chickenpox. If a vaccinated person does get chickenpox, the symptoms are usually milder with fewer or no blisters (they may have just red spots) and mild or no fever.

The chickenpox vaccine prevents almost all cases of severe illness. Since the varicella vaccination program began in the United States, there has been over 90% decrease in chickenpox cases, hospitalizations, and deaths.

At a Glance

Chickenpox is a highly contagious disease caused by the varicella-zoster virus (VZV). It causes an itchy, blister-like rash. The rash appears first on the chest, back, and face, and then spreads over the entire body.

Chickenpox used to be very common in the United States. In the early 1990s, more than 4 million people got chickenpox, 10,500 to 13,000 were hospitalized, and 100 to 150 died each year. Chickenpox vaccine became available in the United States in 1995. During the first 25 years of the U.S. chickenpox vaccination program, the vaccine has prevented an estimated 91 million cases, 238,000 hospitalizations, and 2,000 deaths.

CDC recommends two doses of chickenpox vaccine for children, adolescents, and adults who have never had chickenpox and were never vaccinated. Children are routinely recommended to receive the first dose at 12 through 15 months of age and the second dose at 4 through 6 years of age.

Who Needs Chickenpox Vaccine

Children under age 13 years should get two doses:

• First dose at age 12 through 15 months.
• Second dose at age 4 through 6 years.

The second dose may be given at an earlier age if it is given at least 3 months after the first dose.

People 13 years of age and older who have never had chickenpox or received chickenpox vaccine should get two doses, at least 28 days apart. Chickenpox vaccination is especially important for:

• Healthcare professionals
• People who care for or are around other people whose body is less able to fight germs and sickness (weakened immune system)
• Teachers
• Childcare workers
• Residents and staff in nursing homes and other residential settings
• College students
• Inmates and staff of correctional institutions
• Military personnel
• Non-pregnant women of child-bearing age
• Adolescents and adults living with children
• International travelers

Some people with a weakened immune system who do not have immunity against chickenpox may be considered for vaccination after talking with their doctor, including:

• People with HIV infection
• People with cancer, but whose disease is in remission
• People on low dose steroids

Who Should Not Get Chickenpox Vaccine

You do not need to get the chickenpox vaccine if you have evidence of immunity against the disease.

Some people should not get chickenpox vaccine or they should wait.

• People should check with their doctor about whether they should get chickenpox vaccine if they:
  • Have HIV/AIDS or another disease that affects the immune system.
  • Are being treated with drugs that affect the immune system, such as steroids, for 2 weeks or longer.
  • Have any kind of cancer.
  • Are getting cancer treatment with radiation or drugs.
  • Recently had a transfusion or were given other blood products.

Types of Chickenpox Vaccine

There are two chickenpox vaccines that are licensed in the United States—Varivax^® and ProQuad^®.

Varivax^®

• Contains only chickenpox vaccine.
• Is licensed for use in people 12 months of age or older.
• Can be given to children for their routine two doses of chickenpox vaccine at 12 through 15 months old and age 4 through 6 years old.

ProQuad^®

• Contains a combination of measles, mumps, rubella, and varicella (chickenpox) vaccines, which is also called MMRV.
• Is only licensed for use in children 12 months through 12 years of age.

Getting Vaccinated After You Are Exposed to Chickenpox

Getting vaccinated after you are exposed to someone with chickenpox can:

• Prevent the disease or make it less serious.
• Protect you from chickenpox if you are exposed again in the future.

A healthcare provider can prescribe a medicine to make chickenpox less severe if you:

• Are exposed to chickenpox.
• Do not have immunity against the disease.
• Are not eligible for vaccination.

Childcare and School Chickenpox Vaccine Requirements

All 50 states and the District of Columbia (DC) have state laws that require children entering childcare or public schools to have certain vaccinations. There is no federal law that requires this.

The Advisory Committee on Immunization Practices recommends that all states require children entering childcare and students starting school, college, and other postsecondary educational institutions to have:

• Age-appropriate chickenpox vaccination.
  • For preschool-age children (age 12 months through 3 years): one dose
  • For school-age children, adolescents, adults: two doses
• Or other evidence of immunity against chickenpox.

Students in school settings have a higher likelihood of spreading chickenpox because they are constantly in close contact with each other.

Chickenpox vaccine prevents the disease and outbreaks in childcare settings and schools. This leads to:

• Less illness and less school time missed by students.
• Less chance of exposing people who cannot get vaccinated.

How Can Parents Pay for Chickenpox Vaccine?

Most health insurance plans cover the cost of vaccines. However, you may want to check with your insurance provider before going to the doctor. If you don’t have health insurance or if your insurance does not cover vaccines for your child, the Vaccines for Children (VFC) Program may be able to help. This program helps families of eligible children who might not otherwise have access to vaccines. To find out if your child is eligible, visit the VFC website or ask your child’s doctor. You can also contact your state VFC coordinator.