If you don't have immunity to Varicella (chickenpox), should you get the whole Varicella vaccine series again?

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Last updated: April 28, 2025View editorial policy

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From the Guidelines

If you don't have immunity to varicella, you should get the whole vaccine series again, which consists of 2 doses of single-antigen varicella vaccine, administered at least 4 weeks apart. This recommendation is based on the most recent and highest quality study available, which emphasizes the importance of varicella vaccination for adults without evidence of immunity 1. The varicella vaccine is crucial in preventing serious liver damage, including cirrhosis and liver cancer, and works by stimulating the immune system to produce antibodies against the varicella virus.

Key Points to Consider

  • The varicella vaccine series consists of 2 doses, administered at least 4 weeks apart 1
  • Adults without evidence of immunity to varicella should receive the vaccine, especially those with close contact with persons at high risk for severe disease or those at high risk for exposure or transmission 1
  • Evidence of immunity to varicella in adults includes documentation of 2 doses of varicella vaccine at least 4 weeks apart, or being U.S.-born before 1980 1
  • The vaccine is not specifically recommended for females with medical indications, but it can be administered to persons with medical indications, with the understanding that the immune response and vaccine efficacy might be less than in persons who do not have medical indications 1

Importance of Vaccination

Varicella vaccination is essential in preventing serious complications, such as pneumonia, encephalitis, and death, especially in high-risk individuals, including healthcare personnel, family contacts of persons with immunocompromising conditions, and international travelers 1. By getting vaccinated, adults can protect themselves and others from the spread of varicella, reducing the risk of morbidity, mortality, and improving quality of life.

From the Research

Vaccine Series and Immunity

  • The provided studies do not directly address the question of whether an individual should get the whole vaccine series again if they don't have immunity to a specific disease, such as diphtheria, tetanus, or pertussis (DTP) 2, 3, 4, 5, 6.
  • However, the studies suggest that combination vaccines, such as heptavalent or hexavalent vaccines, can provide immunity to multiple diseases with fewer injections 3, 4, 6.
  • The immunogenicity and safety of these combination vaccines have been evaluated in various studies, and the results indicate that they are effective in inducing immune responses to the included antigens 3, 4, 6.

Disease Tolerance and Immunity

  • One study discusses the concept of disease tolerance as an inherent component of immunity, which involves limiting the health and fitness costs of infection, rather than directly targeting the pathogen 5.
  • This concept may be relevant to understanding the relationship between immunity and vaccine series, but it does not provide a direct answer to the question.

Vaccine Administration and Safety

  • The studies provide information on the administration of vaccines, including the recommended ages for vaccination and the safety profiles of different vaccines 3, 4, 6.
  • However, they do not address the specific question of whether an individual should get the whole vaccine series again if they don't have immunity to a specific disease.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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