Withhold the Varicella Vaccine
A child who has already had confirmed varicella (chickenpox) does not need and should not receive the varicella vaccine, as natural infection provides lifelong immunity that is superior to vaccine-induced immunity. 1, 2
Evidence of Immunity Eliminates Need for Vaccination
A documented history of varicella disease verified by a healthcare provider constitutes evidence of immunity and is a valid reason to withhold varicella vaccination. 1, 2
In this case, the diagnosis was confirmed by a pediatrician and the mother has photographic documentation showing typical varicella lesions, which satisfies the criteria for verified history of disease. 1
The American Academy of Pediatrics explicitly states that evidence of immunity includes "verification of a history of varicella disease or herpes zoster by a health care provider." 1
Natural Infection Provides Superior Protection
Natural varicella infection provides lifelong immunity in immunocompetent individuals, making vaccination unnecessary and redundant. 3
Children who have recovered from natural chickenpox have already developed robust cellular and humoral immunity against varicella-zoster virus. 3
Why Other Options Are Incorrect
Option B (Give vaccine) is inappropriate because vaccinating someone with documented immunity provides no additional benefit and wastes resources. 1, 2
Option C (Postpone) is incorrect because there is no future timepoint at which this child would need varicella vaccination—natural immunity is permanent. 1
Option D (Give immunoglobulin) is only indicated for post-exposure prophylaxis in susceptible individuals within 96 hours of exposure, not for children who have already recovered from the disease. 1
Clinical Pitfall to Avoid
Do not confuse this scenario with catch-up vaccination schedules for unvaccinated children. This child has documented natural disease, which is fundamentally different from being unvaccinated but susceptible. 1, 2
Ensure documentation of the verified varicella history is placed in the medical record to prevent future unnecessary vaccination attempts. 1