New Study Shows Chickenpox Vaccine May Protect Against Shingles in Children

Although shingles is often thought of as a condition that occurs in adults, cases can develop in children. Herpes zoster (shingles) develops after the reactivation of the varicella-zoster virus, the same virus that causes chickenpox. Shingles manifests as a painful rash that generally occurs on one side of the body, usually the face or torso. Complications can ultimately lead to hospitalization and even death. 

A study published in Pediatrics examined the incidence of pediatric shingles over a 12-year period, from 2003-2014, using combined databases from 6 integrated health care organizations.¹ This was a largescale study that included more than 6 million children through 17 years of age and evaluated electronic medical records to determine shingles cases. Children who did not receive the chickenpox vaccine were more than 4 times as likely to develop shingles before age 17 years than individuals who were vaccinated.

The study found that children who received the chickenpox vaccine had a 78% lower risk of developing shingles. Additionally, the overall incidence of shingles declined by 72% between 2003-2014.¹ This coincides with previous studies that have shown patterns of a decrease in pediatric shingles cases among vaccinated children.²

This study further sheds light on the importance of vaccination for protection against chickenpox and shingles, especially since more than 6 million children were evaluated.¹ Since it was an observational study, it is important to keep in mind that cause-and-effect relationships cannot be assessed. However, the data yield strong evidence that should further be evaluated to determine whether vaccination against chickenpox will also result in a decreased incidence of adult shingles cases. 

The chickenpox vaccine first became available in 1995, and children receive their first dose between the ages 12 and 15 months and their second between 4 and 6 years of age.³ Two doses of the vaccine are approximately 98% effective at preventing chickenpox.³ 

Pharmacists can play an important role in counseling parents on the importance of vaccinating their children against chickenpox as it may also protect against shingles. Education is extremely important especially in light of the global antivaccination movement, which has been demonstrated by recent measles outbreaks.        

References                                                          

• Weinmann S, Naleway AL, Koppolu P, et al. Incidence of herpes zoster among children: 2003-2014. Pediatrics. Published online June 10, 2019.  doi: 10.1542/peds.2018-2917. 
• Harpaz R, Leung JW. The epidemiology of herpes zoster in the United States during the era of varicella and herpes zoster vaccines:  changing patterns among children. Clin Infect Dis.  Published online November 29, 2018.  doi: 10.1093/cid/ciy954.
• Chickenpox (varicella) vaccination. CDC website. https://www.cdc.gov/chickenpox/vaccination.html. Last reviewed December 31, 2018.  Accessed June 11, 2019.