The AAP and others are recommending the chicken pox vaccine for all
babies at 12-15 months, given with the MMR. A booster dose may be needed;
it would probably be given at the same time as the measles booster now
being recommended.  The cost benefit analysis
for universal infant vaccination included a large amount of parental work
time loss.  While there is still a lot of chicken pox in the community,
and most kids will still get exposed as preschoolers, parents may choose to
not vaccinate because the natural infection
provides lifelong immunity (in almost all cases), although people can get
shingles later.  Chicken pox is rarely serious or fatal in young
children, although it can be.  It is often quite serious in older
children/teens and especially in adults.  One recommendation I have seen
which seems quite prudent is to immunize 11 year olds who have not had
chicken pox.  Another reasonable approach might be to immunize before the
child starts school.

Breastfeeding may provide minor passive immunity but does not prevent
infection.  Breastfed babies can receive the vaccine.  I believe the
vaccine would be safer than taking the risk of contracting chicken pox for a
breastfeeding mother. It is similar to MMR; neither is contraindicated in
breastfeeding. People can get a few chicken pox at the injection site
which may be contagious.

All adults who are considering the vaccine should have a titer done first
since up to 70% of people who have not had chicken pox are in fact
immune.  Adults need two doses of the vaccine, as opposed to one dose for
children up to age 12.

--
Anne Montgomery, M.D.
[log in to unmask]
St.Peter Hospital Family Practice Residency
Olympia, WA