JCVI recommends chickenpox vaccine in childhood immunisation programme

The Joint Committee on Vaccination and Immunisation ( ) 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 ( ), which will take a final decision on whether to implement a programme.

The 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 , 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 ( ), 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 ’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 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 ministers before any policy decisions are made on a potential new programme.