How can you avoid getting chickenpox?
Chickenpox is highly contagious. If you have never had chickenpox and haven't been vaccinated either, contact with someone who has it will almost always lead to infection. Early vaccination and being careful around those who have chickenpox are the most important precautions you can take.
Chickenpox is caused by a herpes virus known as the varicella-zoster virus. The German Standing Committee on Vaccination (STIKO) at the Robert Koch Institute recommends that people have the vaccination to lower their chances of infection. If you or someone in your family gets chickenpox, there are several things you can do to avoid passing it on to others.
Most importantly, people who have chickenpox should avoid contact with anyone who hasn’t had it and with people who have a greater risk of developing more severe symptoms. This includes, in particular, people with a weakened immune system, newborn babies, and adults who haven't been vaccinated and haven't had chickenpox in the past either. The virus can harm unborn children during pregnancy, and can be life-threatening for newborns. Generally speaking, though, chickenpox rarely has any serious consequences in children who are otherwise healthy. But it can be unpleasant.
How long is chickenpox contagious and how does it spread?
Chickenpox is already contagious 1 or 2 days before the typical rash appears. People usually already have a headache and body pain at that point. Chickenpox remains contagious until the last blisters have dried up and the scabs have all fallen off.
Chickenpox is spread by tiny droplets of saliva released into the air when someone who is contagious breathes, coughs, sneezes or speaks (this is sometimes called “droplet infection”). The viruses may also spread through direct contact or by touching objects or clothing.
One thing many people don't know is that you can also get chickenpox from contact with people who have shingles. They may spread the varicella-zoster virus through direct contact, but not through droplets in the air. Shingles is a possible long-term consequence of chickenpox. It can develop years or even decades later.
Who is the chickenpox vaccination recommended for?
As of August 2004, the German Standing Committee on Vaccination (STIKO) at the Robert Koch Institute recommends that all children have a chickenpox vaccination (varicella vaccination). STIKO's recommendation is a first vaccination between the ages of 11 and 14 months and a second one between the ages of 15 and 23 months. Depending on the specific vaccine that is used, the two vaccines should be given at least 4 to 6 weeks apart. The vaccine is injected. It can be given at the same time as a combination vaccine known as the MMR vaccine, which vaccinates against measles, mumps and rubella (also known as German measles). A combination vaccine against measles, mumps, rubella and varicella (MMRV vaccine) is also available.
Other groups of people are also advised to get vaccinated if they haven't yet had chickenpox. These include teenagers, women who are hoping to get pregnant, and people who have certain other conditions, such as severe eczema. You can find more information about the varicella vaccination and STIKO’s recommendations on the Robert Koch Institute website.
People who have been vaccinated can still get chickenpox. That is rare, though, and the symptoms are usually milder then. The risk of complications is lower, too.
What if you're not immune and come into contact with someone who has chickenpox?
If you have never had chickenpox and are not vaccinated, you can get vaccinated within five days of coming into contact with someone who is infected. Studies involving a total of 110 healthy children whose siblings had chickenpox showed that:
- Without the vaccination: About 78 out of 100 healthy siblings who were not vaccinated after contact developed chickenpox.
- With the vaccination: About 23 out of 100 healthy siblings who were vaccinated after contact developed chickenpox.
So getting vaccinated after contact prevented chickenpox in 55 out of 100 children. The vaccinated children who still got chickenpox generally had a milder form than children who were not vaccinated.
Chickenpox vaccinations should not be given during pregnancy. If a pregnant woman who has not been vaccinated and isn't immune comes into contact with someone who has chickenpox, she should see a doctor quickly. Within four days of contact, special antibodies can be injected to fight the virus. This is called “passive immunization.” It can stop chickenpox from developing fully, or at least lessen the symptoms. Passive immunization is also an option for newborns if their mother develops chickenpox a few days before or after giving birth. It is done to try to protect the baby from severe symptoms.
How can you avoid infection in everyday life?
If someone in your family has chickenpox, the following precautions may help lower the risk of infection:
- Call the doctor first to let them know you will be coming in with a suspected case of chickenpox, and ask what you should do when you get there. People who are thought to have chickenpox are usually taken to a separate waiting room so they don't infect others. The doctor might be able to make a home visit instead.
- Wherever possible, the person who has chickenpox should avoid contact with anyone who has never had it. That also means not spending much time in a room with other people because chickenpox can also be spread through the air.
- Children with chickenpox are not allowed to go to school or daycare. They should also not play with other children until they are no longer contagious.
- Try to avoid scratching blisters because they may break and the fluid inside is contagious. It may help to keep children’s fingernails trimmed, and put cotton mittens on babies’ and toddlers' hands.
Macartney K, Heywood A, McIntyre P. Vaccines for post-exposure prophylaxis against varicella (chickenpox) in children and adults. Cochrane Database Syst Rev 2014; (6): CD001833.
Robert Koch Institute (RKI). Empfehlungen der Ständigen Impfkommission (STIKO) am Robert Koch-Institut - 2018/2019. August 23, 2018. (Epidemiologisches Bulletin; Band 34).
Robert Koch Institute (RKI). RKI-Ratgeber: Varizellen (Windpocken), Herpes zoster (Gürtelrose). December 13, 2018.
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