To ask for opinions on varicella vaccine vs natural immunity?

[Moopp]

I am not an anti vaxxer - me and my kids have had every vaccine offered so far. My kids will be eligible for a single dose of vaccine in the next year on the NHS. They have not yet had chickenpox, as there's only been one outbreak locally and we missed it.

The varicella vaccine offers protection for 10-20 years, and many people may get lifelong immunity, but it's only been in use since the 90s so it's presumably actually an unknown.
Natural infection generally offers lifelong protection.

My options:

• try to get the kids infected naturally before their vaccine appointment comes through. Very low risk of serious complications as they are both healthy, age 3 and nearly 5. They get lifelong protection.

• get them a single dose of vaccine, which offers 95% protection for 10-20 years (maybe more). They might then contract chickenpox in adulthood and it is much nastier for adults.

I will not leave them both unvaccinated AND uninfected, as I want to contribute to herd immunity. That's not an option.

Obviously eventually we might as a country get to a point where so many people being vaccinated means there is so little chickenpox circulating that their chances of catching it as older adults is really small. But that relies on vaccine uptake (or natural immunity) being above 80% I believe, and I'm not sure I have that much faith in people's decision to choose to vaccinate anymore. It will be generally offered with MMR, and uptake for that is currently 84% and declining.

It's worth mentioning that both my kids are boys, so I don't have to worry about the additional risk of them getting chickenpox in pregnancy should their vaccine based immunity wear off in less than 40 years.

If anyone is really knowledgeable about long-term varicella vaccine immunity I'd really value your input. Also I'm just interested if anyone has a perspective I haven't thought of.

But chickenpox as an adult is exactly what I am trying to avoid for them! Perhaps my OP wasn't clear.
If I manage to get them CP as children, it's very very unlikely they'll get it again as adults. But if they'll get a vaccine, in theory that could wear off in 20 years and they could then get CP as adults.

I'm in Australia in a relatively high vaccine accepting area. I do not know a child who has had chicken pox.

My little boy caught chickenpox at nursery at 21 months old. It was awful.

Paid for DD to have the vaccine at Boots as soon as she was old enough. £150 for both doses. Chickenpox has done the rounds at her nursery about 5 times since, and most of the children in her room have had it. The parents I’ve spoken to thought it was pretty awful for their kids too.

No regrets.

Many countries have been vaccinating for decades and continue to do so, so I imagine the long term cost vs risk deems it worthwhile continuing to vaccinate. I recall reading a study that illustrated there was not a higher prevalence of chicken pox in adults in vaccinated countries vs unvaccinated, but I don't remember the details sorry.

My DD caught chicken pox when she was about 16 months, I had researched and wanted to get her jabbed privately but was waiting for a window of no colds or bugs (never ending in nursery!). Luckily there were no long term ill effects BUT she was so poorly. She was absolutely covered in them and so miserable. I felt so so guilty not to have organised a vaccine sooner and avoiding all that anguish for her. It also meant taking two weeks off work which had a financial impact.

Thanks, this is helpful.

This isn't correct. Shingles is caused by a reactivation of the chicken pox virus that has laid dormant after a previous chicken pox infection.

Shingles can also cause long-term neuropathic pain. I got it as a teenager and still have an area of my back that feels like someone's sticking 100s of pins in it if my husband so much as gently strokes it. It's exactly where I had the worst blisters when I got shingles. So, you might want to factor that risk in when making a decision about the vaccine.

My paediatrician said the reason for the vaccine was economic not for child welfare in his opinion. They had all other vaccines offered

This is exactly the kind of information I'd been hoping to find. I have read some studies on long term immunity, but haven't seen anything with this figure. Do you remember where you read it by any chance?

Even if it did wear off (which it shouldn't) they can just get a booster.

I remember getting chickenpox as a kid. I wouldn't wish it on my worst enemy.

Have you read what the JCVI said in the explanation of why they’ve now recommended it?

Basically they can only say it has been shown to have X amount of years of immunity because it’s only been in use those years, but they’ve said that the previous belief that it would wane in 10-20 years leading to a risk of CP in adults and also could lead to an increased risk of shingles have both been shown not to be the case.

Theres no evidence of immunity waning, but they can’t say it’ll last for 40/50/60 years yet because it’s not been in use that long. They can say that the first groups to have it - which is decades ago now - have been shown to still have immunity and no increase in shingles risk (lowered in fact).

I can't remember where I read the 25 y figure but the govt website states that the effectiveness doesn't decline over time. https://ukhsa.blog.gov.uk/2025/12/17/what-is-the-mmrv-vaccine-and-is-my-child-eligible/

Surely the fact that risk of shingles is lower is an excellent reason to get the vaccine? Shingles is horrific. I would (and will) 100% vaccinate. It’s safe and effective.

It's not true that immunity only lasts 10-20 years. If that were the case there would be a booster programme. It's actually that we don't know how long immunity lasts - but as the earliest vaccinations are 25+ years ago and there's no sign of loss of immunity, we can probably assume it's lifelong.

My son had the vaccination in 2020 when he was 1, and we were told to consider getting him a booster before he goes to uni just to make sure he's covered. But that is just a back-up, they didn't really think it was necessary. He's been through numerous outbreaks at nursery and school without any sign of pox.

Incidentally, immunity from infection isn't foolproof - you can be infected again. I have a friend with an autoimmune condition who's had it three times (badly).

My US colleagues were absolutely horrified when they found out UK children still get chicken pox because we don't (at the time I spoke to them about it) vaccinate. To them it's an old-fashioned illness that no-one nowadays gets.

We did the private vax as had 2 nd kids whom i just knew would pick and scratch and have scars when it was ripping around nursery! I do worry about long term immunity for dd and will maybe get a booster for her T 20?

to put it in context , a simple mosquito bite almost leas to a hospitalisation as Ds could not stop picking and scratching

I had a really sensible conversation with a prescribing pharmacist about this, as had the same concern.

Once upon a time I studied a reasonable amount of proper science, and was comfortable with the explanation although cant recall the full details.

The rough summary was that because of the mechanism through which this vaccine works, and the recognised behaviour of the virus and immune response - the immunity from the vaccine should be equivalent to the immunity from catching chicken pox.

The regulations about drug efficacy are very tight, so it cant be reported as providing life long immunity until it’s been studied for a standard lifetime. It’s been studied for a couple of decades, so that’s where those figures come from.

It’s pretty well recognised that chicken pox as an adult is more problematic than as a child, and a fairly wide range of countries have made the vaccine part of their standard regime. I like to think that if there was any evidence pointing towards effectiveness waning with time (as opposed to not being proved yet) that that approach wouldn’t be as wide spread.

@Moopp but the problem is having chicken pox as a child doesn’t guarantee lifelong protection either. Many people get chicken pox twice - with those with lower immune systems most likely but it’s not impossible even if you’re immunocompetent. Last time I spoke to a microbiologist about it the figures quoted was 95% lifelong immunity with vaccine and 98% with natural immunity - to me that’s basically exactly the same so I would much rather vaccinate (which is what I paid to do) and also not have to deal with a childhood illness and associated time off school (until all the lesions have scabbed over).

Also there’s no definitive test for chicken pox - it is a clinical diagnosis based on blistering which can look similar to other childhood illnesses - your child may be misdiagnosed as having chicken pox and then actually have no natural immunity in adulthood anyway. If you’re main concern is their immunity when their older I would personally get them BOTH doses of the vaccine not one - as you’re maximally protected a few weeks after the second dose, rather than leaving it to chance

You mention that both your children are boys which means you’re less worried about the immunity in pregnancy but what if they meet a female who anlso has no antibodies who becomes pregnant and then and your son gets chickenpox pox ? Or have a female pregnant colleague. Or what if your child develops (god forbid and I mean this sincerely) a condition which requires immunosuppression - arthritis/ psoriasis/ cancers / inflammatory bowel disease even asthma - if they’re on these medications and develop chicken pox it is much more likely to be severe. Luckily with it becoming free on the NHS hopefully by the time your kids are older there will be more herd immunity and less likelihood of this.

I'd get them vaccinated. I had it as a child but then caught it again in my 30s. I was pregnant at the time. It can be a dangerous illness for the unborn baby and pregnant women, and I was very lucky that my child had no lasting effects when they were born.

Even if they don’t have serious complications, their experience of it can still be awful. I got the vaccine privately for my child.

Thank you, very helpful.

I’m in hospital on IV antivirals for shingles. I’ve been here six days. It is horrible. Anything I could do to avoid that would be worth it.

Thanks all for the input, I really appreciate it.

I think we will probably get the single vaccine the NHS are offering, and then try to find the money to pay for the second dose ourselves. I don't want to leave them half-protected, in case it wears off sooner with only one dose as some things I've read suggest.

My dd had CP at 9m old in 2012, she was so unwell and her nappy area was open weeping sores, it was horrific. I still wonder how she isn't more scarred from the hundreds of spots she had. I got ds vaccinated, 2 doses, privately in 2014, no regrets. I'd take the nhs vaccine now, no hesitation .

Can they not then get a booster later on?

Are you considering the week of your child feeling ill and miserable and you having to look after them because they can't go to childcare?

Are they not offering it with the MMR, which is two doses- 1 at 12 months and another aged 3?