Chickenpox, the last of the common vaccine-preventable childhood diseases, is to be added to the free childhood immunisation schedule from 1 July next year. NURSING REVIEW finds out more.
Vaccine funder Pharmac agrees that chickenpox may not be a serious disease for most children.
But in deciding to follow Australia and the United States in adding varicella (chickenpox) vaccine to the childhood immunisation schedule, Pharmac also points out that for some children it is a very serious disease, with more than 220 children under five years old admitted to hospital every year as a result.
The USA’s CDC (Centers for Disease Control and Prevention) says chicken pox vaccination also protects others in the community including those with weakened immune symptoms or pregnant women.
Pharmac decided to go with a single dose varicella vaccine over using the combined MMRV (measles-mumps-rubella-varicella) vaccine, which was associated with increased incident rates of febrile seizures in children aged 12 to 23 months.
This means that children will now receive four injections at their 15-months scheduled appointment but Pharmac was advised by its expert immunisation sub-committee that this was preferable to splitting the 15-months schedule into two visits at 12 and 15 months.
“The current evidence indicates that if the vaccinator is confident in the delivery of multiple injections then the parent or caregiver will be accepting of the number of vaccines,” Pharmac says in announcing its final decision.
Another issue raised during the Pharmac consultation and discussion was whether vaccinating against the varicella-zoster virus that causes chickenpox increases the risk of people getting shingles – the disease caused by reactivating the latent virus.
But Pharmac says there is no evidence of a change in the incidence of shingles in the United States (which has had a varicella vaccination programme since 1995) or in Australia, which has funded a varicella immunisation programme since 2005.
Further information and details on introducing the varicella vaccine to the immunisation schedule is expected in the New Year.
SEE RELATED STORY: History of NZ Childhood Immunisation Schedule
Varicella (chickenpox) vaccine (from 1 July 2017)
- From July 1 a single dose will be funded for all children at 15 months (i.e. for children born since April 2016)
- Decision made to go with single vaccine as evidence indicates fewer side effects than when offering MMRV (measles-mumps-rubella-varicella) vaccine option.
- This means four injections will be scheduled for 15-months appointment.
- A single dose will be offered at age 11 in general practice to children who haven’t had chicken pox or a previous varicella vaccine.
OTHER CHANGES
Vaccine brand changes
- Change of Rotavirus vaccine brand and the three-dose regimen will be replaced with a two-dose regimen.
- Also changes of brands for MMR (measles-mumps-rubella) and Haemophilus influenzae type B (Hib) vaccines.
Pneumococcal vaccine
- The 13-valent pneumococcal vaccine (PCV13) will be replaced by the 10-valent vaccine (PCV10) that covers most serotypes in New Zealand.
- Pharmac acknowledges there may be a “small loss” in health benefit but the savings gained would allow widened access to varicella and HPV vaccines, which would provide “significant” health benefits.
- PCV13 would still be available for people considered at risk.
RESOURCES
Immunisation Advisory Centre
Information on chickenpox (varicella) and vaccine:
www.immune.org.nz/diseases/varicella
Resource for health professionals on mitigating vaccination pain and distress:
www.immune.org.nz/resources/mitigating-vaccination-pain-and-distress
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