The Joint Committee on Vaccination and Immunisation (JCVI) has recently made a groundbreaking recommendation to include a universal chickenpox vaccination programme as part of the routine childhood schedule. This programme would utilize the combined measles, mumps, rubella, and varicella (MMRV) vaccine, delivering two doses at 12 and 18 months of age.
This recommendation stems from international evidence demonstrating that a two-dose schedule involving varicella can swiftly and significantly decrease the number of chickenpox cases. The JCVI emphasized the need for a catch-up programme following the implementation of the vaccination scheme.
Government data reveals that approximately 50% of children contract varicella by the age of four, rising to about 90% by the age of 10. However, the reduced social interaction during the pandemic has resulted in a larger population of susceptible children.
While varicella is common among children, it can be more severe in infants under four weeks, adults, particularly pregnant women, and individuals with weakened immune systems. The committee referred to a hospital surveillance study highlighting the frequency and healthcare burden of severe varicella complications.
The JCVI acknowledged a slightly increased risk of febrile seizures associated with the combined MMRV vaccine as the first dose compared to using varicella-only and separate MMR vaccines. Nonetheless, the committee supported the combined product, aligning with parental preferences and reducing the number of injections required during childhood.
Highlighting the potential vulnerability of individuals heading into adulthood due to decreased circulation of varicella, the committee stressed the importance of implementing a catch-up programme to prevent immunity gaps.
Previously, concerns about potential increases in shingles (herpes zoster) cases among middle-aged adults and the shorter-than-expected immunity from exposure to circulating chickenpox deterred the JCVI from recommending a universal varicella vaccination programme. However, recent evidence suggested that such a vaccination programme would unlikely raise shingles incidence.
Experts in children’s health and public health hailed the recommendation, highlighting the prevention of severe chickenpox cases and significant complications associated with the disease.
In light of decreasing childhood vaccine uptake and a rise in measles cases, public health officials have been actively pursuing catch-up campaigns to bolster vaccination rates and protect against preventable diseases.