Should You Get a Varicella Booster After Vaccination Years Ago?
No, you do not need a varicella booster if you received the vaccine years ago, as vaccine-induced immunity remains highly effective over time and does not require routine boosting in immunocompetent adults. 1, 2
Evidence for Long-Term Vaccine Protection
The varicella vaccine provides durable immunity without evidence of clinically significant waning:
A 14-year prospective study demonstrated 90% vaccine effectiveness with no indication of waning immunity over time, even among children followed from their second year of life through adolescence 2
Current U.S. guidelines recommend only 2 total doses of varicella vaccine for lifetime protection - one dose for those vaccinated in childhood before the 2-dose recommendation, or two doses given 4-8 weeks apart for those vaccinated after age 13 1
The CDC and ACIP do not recommend booster doses beyond the standard 2-dose series for immunocompetent individuals 1
What Constitutes Evidence of Immunity
You are considered immune to varicella if you have any of the following 1:
- Documentation of 2 doses of varicella vaccine at least 4 weeks apart
- Documentation of 1 dose if you were vaccinated as a child before 2006 (when the 2-dose recommendation began)
- History of chickenpox disease verified by a healthcare provider
- Laboratory evidence of immunity (positive varicella IgG)
- U.S.-born before 1980 (though this alone is not considered sufficient evidence for healthcare workers)
When a Second Dose May Be Indicated
If you only received one dose of varicella vaccine years ago, you should receive a second dose to complete the series 1:
- The second dose should be given at least 4 weeks after the first dose 1
- This is not technically a "booster" but rather completion of the recommended 2-dose primary series
- Two doses provide 92% effectiveness compared to 81% for one dose 1
Special Considerations
If You're Uncertain About Your Vaccination History
- Serologic testing is generally not recommended before vaccination due to low test sensitivity for detecting vaccine-induced antibodies 1, 3
- If you have no documentation and uncertain history, you can safely receive the 2-dose series 1
- Revaccination of already-immune individuals is not harmful 1
Immunocompromised Patients
- If you are or will become immunocompromised, different recommendations apply 1
- Consider the recombinant zoster vaccine (Shingrix) instead if you're age 50 or older or have specific risk factors, as this protects against shingles without using live virus 4
Common Pitfalls to Avoid
- Do not confuse varicella (chickenpox) vaccine with zoster (shingles) vaccine - these are different vaccines for different purposes 4
- Do not assume you need routine boosters - unlike tetanus, varicella vaccine does not require 10-year boosters 1, 2
- Do not get serologic testing to determine if you need vaccination - the CDC specifically advises against this approach due to test limitations 1, 3
Bottom Line
If you received 2 doses of varicella vaccine at any point in your life, no booster is needed. If you only received 1 dose, complete the series with a second dose. If you're completely uncertain about your vaccination history and have no documentation, receiving the 2-dose series is safe and appropriate. 1, 2