For children, the first dose should be given at age 12 months with a second dose given at age 4 through 6 years. The second dose could be given earlier, if necessary, as long as there is a 3-month (12-week) interval between doses. Although a 3-month minimum interval is recommended in children younger than age 13, the second dose does not need to be repeated if separated from the first dose by a shorter interval of at least 4 weeks.
All children age 13 years and older as well as adults without evidence of immunity should also have documentation of 2 doses of varicella vaccine, separated by a minimum interval of 4 weeks.
Last reviewed:
May 16, 2023
Don’t delay giving the second dose of varicella vaccine. Give the second dose the next time the child is in your office. The recommendation to routinely give a second dose at age 4 through 6 years is intended to provide improved protection in the 15% to 20% of children who do not adequately respond to the first dose.
Last reviewed:
May 16, 2023
Postvaccination serologic testing for varicella immunity is not recommended in any group, including healthcare personnel.
Last reviewed:
May 16, 2023
Varicella postvaccination serologic testing is not recommended; however, if a person tests positive for varicella antibody 28 days or more after vaccination, the Advisory Committee on Immunization Practices (ACIP) considers the person to be immune. Studies have shown that a second dose boosts antibody titers and indicators of cell-mediated immunity significantly above the levels produced by a single dose. A second dose may be required to comply with school entry or institutional immunization requirements, regardless of serologic test results. You can access the ACIP varicella vaccine recommendations, which include evidence of immunity (page 16) at www.cdc.gov/mmwr/pdf/rr/rr5604.pdf.
Last reviewed:
September 5, 2023
Test pregnant people who lack either (1) documentation of receipt of 2 doses of varicella vaccine or (2) healthcare provider diagnosis or verification of varicella or herpes zoster disease. Those who are not immune should begin the 2-dose vaccination series immediately postpartum.
Last reviewed:
May 16, 2023
Commercially available laboratory tests for varicella antibody are usually based on a technique called EIA (enzyme immunoassay). Though these tests are sufficiently sensitive to detect antibody resulting from varicella zoster virus infection, they are generally not sensitive enough to detect vaccine-induced antibody. The more sensitive assays needed to detect vaccine-induced antibody are not widely available. This is why CDC does not recommend antibody testing after varicella vaccination.
Last reviewed:
May 16, 2023
If you cannot verify a healthcare employee’s history of chickenpox, the employee should receive 2 doses of varicella vaccine at least 4 weeks apart. For details, refer to pages 16 and 26 of the CDC recommendations Prevention of Varicella at www.cdc.gov/mmwr/pdf/rr/rr5604.pdf.
Last reviewed:
May 16, 2023
No. Documented receipt of 2 doses of varicella vaccine supersedes results of subsequent serologic testing. Most commercially available tests for varicella antibody are not sensitive enough to detect vaccine-induced antibody, which is why CDC does not recommend post-vaccination testing. For more information, see page 24 of ACIP’s Immunization of Health-Care Personnel, available at www.cdc.gov/mmwr/pdf/rr/rr6007.pdf.
Last reviewed:
May 16, 2023
The recommended minimum interval between two doses of varicella vaccine for children 12 months through 12 years of age is 12 weeks. However, the second dose of varicella vaccine does not need to be repeated if records show it was separated from the first dose by at least 4 weeks. See www.cdc.gov/vaccines/hcp/imz-best-practices/timing-spacing-immunobiologics.html, Table 3-2.
Last reviewed:
May 16, 2023
