The BAG now recommends the chickenpox vaccination – the 11 key points

Varicella, also known as chickenpox or smallpox, is caused by the varicella-zoster virus and is distributed worldwide. Chickenpox is highly contagious and is mainly transmitted from person to person via droplets. An infected person can infect ten to twelve people. Chickenpox causes a low-grade fever and red spots that often spread all over the body and form itchy blisters.

“Chickenpox is often relatively harmless, but extremely annoying. But there are also serious course and complications », says Anita Niederer, an infectious disease specialist at the Children’s Hospital in Eastern Switzerland. This year in particular, the children’s hospital treated an above average number of serious cases of chickenpox. These are usually bacterial superinfections, but other complications such as vascular inflammation can also occur. According to the BAG, two out of every 100,000 infected children die from chickenpox.

Much more dangerous than with children. In Switzerland, about 3,000 adults over the age of 16 contract chickenpox each year, and on average about 140 are hospitalized because they suffer from brain or pneumonia. For every 100,000 adults infected, 30 people die. The older someone is, the more often serious complications occur. After infection, the varicella-zoster viruses become trapped in the nerve cells of the spinal cord, where they remain for life. In a third of people who get chickenpox, these viruses cause shingles later in life when the immune system weakens.

No. “It has been around for decades. It has been part of the Swiss basic vaccination plan for years,” says pediatrician Anita Niederer. Until now, however, the vaccination advice only applied to children who had not had chickenpox until the age of eleven. Since January 2023, the Federal Vaccination Commission and the FOPH to vaccinate all children to eventually achieve herd immunity against chickenpox, which is achieved after several years or decades and after an immunity of 80 to 90 percent of the population.For example, the vaccine has been a standard vaccination in the U.S. since 1996 Vaccination against varicella has been recommended for many years in 45 countries.

Vaccination against chickenpox is recommended as a two-dose primary vaccination course for all infants aged 9 to 12 months. Vaccination is done with a combined MMRV vaccine that protects against four diseases: measles, mumps, rubella and chickenpox. In addition, a catch-up vaccination against chickenpox is recommended for anyone between the ages of 13 months and 39 years who has not yet had chickenpox and has not yet received a total of two doses of the vaccine.

There is an increased risk of complicated varicella diseases. But that’s not the reason for the new recommendation, says Christoph Berger, chief physician for infectiology at the University Children’s Hospital Zurich and chair of the Federal Vaccination Commission. There were other reasons for changing the vaccination schedule. First, the availability of MMRV vaccines with durable protection after two doses. This vaccination is 92% effective against varicella and 98% against severe courses. The vaccination is also recommended because there is no increase in the risk of shingles in adults after the introduction of the vaccination for children. According to Berger, it is also possible to reduce the burden of complicated chickenpox in vulnerable children and adults who cannot be vaccinated. Because they are less likely to be infected by others.

The vaccination also significantly reduces the risk of shingles. In addition, the indirect costs of chickenpox are reduced. “If a child is ill for a week, parents often have problems with childcare. You can prevent that with a little effort, with a safe, well-established vaccination,” says Niederer.

“On the contrary. Going through the disease carries a risk of complications, the vaccination does not. Secondly, the risk of herpes zoster, shingles, is much higher without vaccination,” says Niederer. One in three people who have had chickenpox will develop it risk of getting shingles.The risk increases with age.

In the short term, the quadruple vaccination can lead to fever. However, this is generally rare and occurs especially after the first dose, Niederer says. Any fever after the vaccination does not pose an additional risk, even at the age of 9 months. “Fever is a reaction that shows that the child’s immune system is processing the vaccine, but this is not dangerous,” says the infectious specialist at the children’s hospital. in eastern Switzerland.

Anyone who grew up in our latitudes has had chickenpox with a 98 percent chance. Those who were infected and are still vaccinated do not take any risks. “If someone already has antibodies to the varicella-zoster virus in their body, the vaccine virus is neutralized and excreted again,” says Niederer. “The vaccination can do no harm, but then there is no point. Alternatively, the antibodies can be measured in individual special cases,” says Berger.

Yes. “Vaccination is the primary prevention of shingles. The highly weakened vaccine virus causes much, much less shingles than in people who have had chickenpox,” says infectious disease specialist Berger. The risk of shingles arises with infection with chickenpox. Children who are vaccinated against chickenpox today and therefore remain chickenpox-free have a significantly reduced risk of developing shingles later in life. They probably don’t need to be vaccinated against shingles when they are 60 years old.

No. Our immune system has to deal with countless foreign substances and antigens every minute. Even in the first few hours of life, our gut is colonized with billions of bacteria, all of which are potentially dangerous. If the immune system could not handle several hundreds of thousands or even more antigens at once, we would not survive. Whether antigens from ten or eleven vaccinations are added does not matter at all, according to Anita Niederer. “The problem is the perception, because that’s what you do with the syringe. But from an immune system burden point of view, that’s nothing,” says Niederer. Berger also says: “It is no problem at all to get vaccinated against various diseases if, as in the cases mentioned, it is a good vaccination.”