Chickenpox vaccine timing

[Writerz34]

Hello - I want my baby to have the chickenpox vaccine asap, and have seen many places offer it from 12 months - but some from 9 months. I assume if from 12 months, you'd get the usual 1 year injections and then do the chickenpox at 13 months (as need to wait 4 weeks between them) - is that right? I haven't been able to find evidence about if it's better to do it this way, or better to go somewhere that offers it from 9 months so the 1 year vaccines can happen as normal.

I'm thinking maybe the advice about 12 months is for if it's ever rolled out on the NHS - as then they'd combine with MMR, but it doesn't seem like MMRV is even available privately in the UK yet - and therefore it's still effective from 9 months, they're just factoring in the admin in there 12 month recommendation.

Any advice / links to evidence on these options would be welcome! (No need for anything anti vax, baby will definitely have them all, I'm just asking about timing / sequencing)

The chickenpox vaccine is 2 vaccines, something like 8 weeks apart. You cannot give ibuprofen in the weeks after. Not available on NHS; you'll have to pay privately. Boots do it.

We are planning to get our 18 month old vaccinated soon, one of my friends organised via her doctors for her little one to get it at the same time as her 12 month jabs. I wish I’d had the foresight to do so! I would call your GP practice and see whether they offer the same, obviously you would need to pay but the fewer vaccination sessions the better in my opinion!

We planned to do it at 13 months but my son was just starting nursery so decided to wait then holidays/Christmas etc and we just haven’t got round to it! Going to call and book it in today, thanks for the reminder!

Thanks - yes it's 4 weeks apart, so I'm wondering if it's better to do it at 9&10 months, 10&11, or 13&14 (to fit around the usual 12 month vaccines) - or if it makes no difference - or if MMRV is available anywhere in the UK (doesn't look like it from Google)

When I was looking into this the data I found suggested that slightly later vaccination was slightly more effective, but we opted to get it at 9 months to try to minimise the risk of her being infected before she could be vaccinated, as she regularly attended baby/toddler groups, and chickenpox is EVERYWHERE. Unfortunately she caught chickenpox at 12 months before she could have her second dose, but it was likely milder than it would have been if she hadn't had the first dose when she did.
I think if you don't go to baby/toddler groups or soft plays etc where this sort of thing is rife then I'd probably wait until 13 months, but if your baby is going to be at regular risk of exposure then sooner is better, and the difference in effectiveness is minimal.

Oh I had thought places wouldn't do it at the same time as the usual 12 month ones! Agree that could be best, get them out the way! I think my GP don't do private vaccines though so then I'd have to get the whole lot done privately to do it together, but worth it to limit the number of trips to the doc!

Thanks @pbdr - that's what I was thinking - we are often at these types of places. Any chance you still have links to any of the data you looked at? I can't find anything on effectiveness at 9 Vs 12 months...

I don't think I managed to find anything directly comparing exactly 9 months vs 12 months, but this might be of interest;

academic.oup.com/jid/article/186/1/102/836901

It needs to be the same day or four weeks apart

You can get it on the same day as the 12 month ones, if you don’t want to wait the 4 weeks. You can get the usual ones at the GP in the morning then go to Boots or wherever that afternoon- a doctor told me this was fine, whether or not the pharmacist would be happy to do it IDK though as it’s not the usual done thing and their literature says 4 weeks. Or more expensive option but if you want it over and done with as efficiently as possible then go to a private GP and have them do all the vaccines together- we did this for DD.

Doesn't need to be at the same place though, could do a GP appointment and then head to Boots

Ooh good thinking. Maybe we do the first chickenpox dose at 11 months for earlier protection and then combine the second dose with the usual 12 month vaccines. Thanks all !

I booked the private chickenpox vaccine on the same day as the mmr and four weeks later. Maternal antibody interferes with the live vaccines (mmr and vzv) so particularly of breast feeding, if you get one prior to a year, it's often recommended to have two more doses after a year - that's what is recommended for babies who are given mmr early if exposed to measles in an outbreak. Otherwise you may not get protective efficacy. It all depend on maternal IgG which varies widely depending on her recent exposure, health, placental health, etc etc

I would go for the earlier schedule if baby is starting nursery. We went for 13 and 14 months as didn’t know it was available from 9 months and there was already a chicken pox scare in the first few weeks of nursery.

The JCVI has recommended that the chicken pox vaccine gets incorporated into the 12 months vaccines with the second one at 18 months so I would go as close to that as is feasible. https://www.gov.uk/government/news/jcvi-recommends-chickenpox-vaccine-in-childhood-immunisation-programme#:~:text=A%20childhood%20varicella%20(chickenpox)%20vaccine,and%2018%20months%20of%20age.&text=The%20Joint%20Committee%20on%20Vaccination,UK's%20routine%20childhood%20immunisation%20programme.

I would avoid if you can doing vaccines 3 months in a row. We had to do this as my daughter had to have her 1 year vaccines individually and the stress and tole of having her home for a few days to recuperate was draining especially when adjusting to working life. I would be tempted to do 12 months vaccines the chicken pox at 14 and 16 months.
I wouldn't book it before 12 months until you know how weaning is going. My daughter was very slow to wean and at 9 months we wouldn't have wanted to introduce any additional reasons for her to go off the little food she was willing to eat.

Can you provide any links to this? I've breastfed two kids and no NHS health professional has ever raised this issue (despite me actually breastfeeding during the jabs themselves, so very clearly they were breastfed babies). If there's evidence that breastfeeding affects the efficacy of those vaccines, then I would expect the NHS to raise this as part of the vaccine programme? Otherwise it's just scaremongering

We had no side effects after the 12 month vaccinations or either of the chicken pox ones and didn’t need any time off work or nursery for any of them (we did have some with the earlier vaccines). She had her 12 month ones the day after her birthday and chicken pox a month later. My reasoning was to get her protected as soon as possible if going to nursery as it really is a breading ground for every known germ.

Our nursery at the time wouldn't let you back for 24h after a vaccination so even for the jabs she didn't react to she was off for 2 days - one day to go to the hospital/GP and 1 day for 24h wait. For the MMR (at 15/16 months) she also had chicken pox so was out for 5 days and the menB she was off for nursery for 2 days with the 3rd day she would have off was my non working day. When she had the menB at 4months it put her in hospital. She didn't have bad reactions to any of her 12 months jabs just temperatures and needing cuddles but enough to warrant being at home. It was disruptive to our routine though when we were just adjusting to a routine

Our current nursery has no rules about going back after vaccines and went in straight after her flu vaccine in the winter.

@sexnotgenders I'm specifically talking about giving live vaccines early www.sciencedirect.com/science/article/pii/S0264410X15010634
This is a well recognised phenomenon and why our vaccine schedule is constructed as it is with mmr being given at 12months and not sooner. It's a balance between risk of measles disease and vaccine efficacy. It's also why they get two doses.

See screenshot from cdc and uk measles guidance below see page 33

assets.publishing.service.gov.uk/media/65a7a806867cd800135ae9bb/national-measles-guidelines-january-2024.pdf#page25

The amount of maternal milk drunk and antibody content decreases over time and Trans placental antibody falls so interference changes.

Breastfeeding around the oral rota virus and oral polio vaccines can prevent them from taking so when we did studies in low resource settings we try to discourage breastfeeding for a while before and after they're given to help efficacy.
I breastfed my children and strongly support anyone who wants to breastfeed. But we do plan interventions like vaccines around these things!

Thanks @chillichoclove that's really helpful and informative. There's always so much misinformation out there, it's helpful to actually have the science behind discussions around these issues