A review of the pink book, the CDC Vaccine Information Sheet and
Immunization Action Coalition web site did not show that the mode of
transmission from post vaccination vesicular rash was different than from a
wild exposure.  In the discussion among the nurses in our office about
covering the lesions none of us had heard of that and at one time or another
all of us have taken the CDC teleconference courses, one just completed the
most recent.  I will call Merck as it would certainly remove one of the
parental concerns if all they needed to do was cover spots!

The following information was copied from the IAC site
http://www.immunize.org/catg.d/p2021c.htm.  They have an "Ask The Experts",
a service anyone can use to ask vaccine related questions.  The questions
are usually answered by William Atkinson, MD or another CDC expert.

 If a child breaks out in 5-10 maculopapular spots 2 weeks following
vaccination, can s/he attend school?
Transmission of varicella vaccine virus is a rare event, and appears to
occur only when
    the vaccinated person develops a vesicular rash. A maculopapular rash 2
weeks after
    varicella vaccine may not have been caused by the vaccine. If the rash
were caused by
    the vaccine, the risk of transmission is very small. The child's
activities, including
    attendance at school, do not need to be restricted. (3/99)

    If a vaccinated child gets 5-10 vesicular lesions 2 weeks after
    vaccination, can s/he attend school?
    You cannot distinguish a mild case of varicella disease from a rash
caused by the
    vaccine. The child may have been infected with varicella at about the
same time s/he was
    vaccinated. The conservative approach would be to treat the child as if
s/he had
    chickenpox and restrict his/her activities until all the lesions crust
over. (3/99)

    If a child gets breakthrough varicella infection, ~50 lesions, can s/he
    go to school?
    Breakthrough varicella represents replication of wild varicella virus in
a vaccinated
    person. Although most breakthrough disease is very mild, the child is
contagious and
    activities should be restricted to the same extent as an unvaccinated
person with varicella
    disease. (3/99)

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