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The Revised Authoritative Guide To Vaccine Legal Exemptions

Vaccines Have Serious Side Effects

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The Advisory Committee on Immunization (ACIP) has recommended that all children entering child care facilities and elementary schools have received VZV vaccine or have other evidence of varicella immunity (physician diagnosis of varicella, reliable history, or serologic evidence (51). Because the risk of severe varicella is high in adolescents and adults, vaccine is indicated in susceptible individuals over the age of 12 at high risk for exposure including those living or working in environments where transmission of VZV is likely or can occur, those living in households with children, nonpregnant women of childbearing age, and international travelers.

Vaccine should not be given to patients with cellular immunodeficiencies because of the risk of severe vaccine associated varicella but VZV vaccine can be given to patients with humoral immunodeficiencies and asymptomatic or mildly symptomatic (age-specific CD4+ T-lymphocyte percentage of > 25%) HIV-infected children. Pregnant women should not receive the vaccine because of concerns of fetal varicella syndrome and the increased risk of severe varicella in late pregnancy. Routine universal VZV vaccination will decrease the booster effect from exposure to wild-type virus which may lead to waning immunity among vaccinees, thus requiring booster vaccinations to prevent severe varicella infections later in life.

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