The Joint Committee on Vaccination and Immunisation (JCVI)
has recommended a vaccine against varicella, commonly known as
chickenpox, should be added to the UK’s routine childhood
immunisation programme.
The vaccine would be offered to all children in 2 doses, at 12
and 18 months of age.
The committee has submitted its
recommendations to the Department of Health and Social Care
(DHSC),
which will take a final decision on whether to implement a
programme.
The JCVI has
also recommended a temporary catch-up programme for older
children be included in the initial rollout. Chickenpox cases
were significantly reduced during the pandemic due to social
restrictions, meaning there is currently a larger pool of
children than usual without immunity. The catch-up programme
would offer them protection against greater risks from the
illness through later childhood or as adults, when chickenpox can
be more severe.
If approved, it would bring the UK into line with other countries
offering routine varicella vaccination, including Germany,
Canada, Australia and the United States, the latter of which has
had a childhood programme in place since 1995. All have observed
significant decreases in the number of cases of varicella and
resulting hospitalisations.
Varicella, or chickenpox, is a highly infectious disease caused
by the varicella zoster virus. It mostly affects children but can
be caught at any age.
Most varicella cases in children are relatively mild; however,
some children will go on to develop complications, including
bacterial infections such as group A streptococcus.
In rare cases it can cause a swelling of the brain, called
encephalitis, an inflammation of the lungs, called pneumonitis,
and stroke, which can result in hospitalisation and, in very rare
cases, death.
Very young infants aged under 4 weeks are more likely to
experience serious illness, as are adults. Pregnant women are
particularly at risk as it can cause complications in both the
mother and the foetus.
Professor Sir Andrew Pollard, Chair of the JCVI,
said:
Chickenpox is well known, and most parents will probably consider
it a common and mild illness among children. But for some babies,
young children and even adults, chickenpox or its complications
can be very serious, resulting in hospitalisation and even death.
Adding the varicella vaccine to the childhood immunisation
programme will dramatically reduce the number of chickenpox cases
in the community, leading to far fewer of those tragic, more
serious cases.
We now have decades of evidence from the USA and other countries
showing that introducing this programme is safe, effective and
will have a really positive impact on the health of young
children.
Dr Gayatri Amirthalingam, Deputy Director of Public Health
Programmes at the UK Health Security Agency (UKHSA), said:
Introducing a vaccine against chickenpox would prevent most
children getting what can be quite a nasty illness – and for
those who would experience more severe symptoms, it could be a
life saver.
The JCVI’s
recommendations will help make chickenpox a problem of the past
and bring the UK into line with a number of other countries that
have well-established programmes.
In 2009, the JCVI
ruled out a UK-wide programme as evidence at the time suggested
introducing it might cause increased cases of shingles in
middle-aged adults.
Varicella can cause shingles in adults that have previously had
chickenpox, but they benefit from a boost in their immunity
against this when they encounter varicella circulating in the
community.
It was thought that removing community circulation by vaccinating
children would cause a problematic rise in shingles for as long
as 20 years, but a recent long-term study from the USA disproved
that theory.
This evidence, combined with recent research from the University
of Bristol that provided new information on the extent of
chickenpox’s impact on children and the NHS, opened the door for
a UK-wide programme, which the committee has now advised.
The recommendations will be considered in full by DHSC ministers
before any policy decisions are made on a potential new
programme.
