Ask the Experts - Chronic Aspirin Therapy and Varicella Vaccine
Is it contraindicated to give the varicella vaccine to a child on maintenance aspirin therapy given for shunt preservation?

J.D. Mahan, MD

Varicella vaccine was licensed in 1995 for healthy individuals over 1 year of age with no past history of varicella or shingles. While it may be acceptable to immunize children with certain chronic health problems, such as asthma, even if they receive steroid therapy, children who are receiving chronic aspirin therapy for any reason should not be immunized, according to the package insert. This is because of the association of natural clinical varicella and Reye's syndrome with use of aspirin to control fever.

Since aspirin is no longer given to children with varicella or influenza, Reye's syndrome has become a very rare disease in the United States. No cases of Reye's syndrome have been associated with aspirin therapy and varicella vaccination, but because aspirin is a contraindication to vaccine use, data on the problem would not be expected to exist.

Because varicella vaccine is associated with herd immunity, it is hopefully now less likely that an unimmunized child will become exposed to wild-type varicella-zoster virus. Healthy siblings in the family who qualify for varicella vaccine should receive it, to help protect the child on aspirin therapy from becoming infected with the wild-type virus.