Did you know that chickenpox (varicella) is now a notifiable disease in England? This means that medical professionals must report suspected or confirmed cases to the UK Health Security Agency (UKHSA) from 6th April, 2025. This change is part of a broader update to health protection notification regulations.
Purpose of the Change:
The UKHSA 2025 has stated that this change is essential for maintaining strong surveillance systems, particularly as a potential chickenpox vaccination program is being considered. By requiring notifications, the UKHSA can track trends in chickenpox incidence and monitor the effectiveness of any future vaccination programmes. In November 2023 the Joint Committee on Vaccination and Immunisation (JCVI) recommended that a universal chickenpox vaccination programme is included into the UK routine schedule, see more about this later in our blog.
What is Varicella (Chickenpox)?
Varicella (commonly known as Chickenpox) is a highly contagious infectious disease caused by the Varicella Zoster virus. Infection is characterised by the presence of an itchy, spotty rash with spots appearing then blistering and scabbing over. Other typical symptoms of varicella that may appear one or two days before the rash develops, may include a fever, muscle aches and pains and generally feeling unwell.
Varicella is very common and affects most children during childhood. Most varicella cases in children are relatively mild and the illness resolves without any need for treatment from a medical professional, though most children are unwell for several days and will miss 5 or more days from school or nursery. However, some children will go on to develop complications from Varicella including bacterial infection of skin lesions (including group A streptococcus) and in rare cases, encephalitis, pneumonitis and stroke. These complications can result in hospitalisation and very rarely may result in death.
Varicella is often more serious in very young infants (under 4 weeks) and adults, particularly in pregnancy when it may cause complications in both the mother and the foetus, and in adults who are immunosuppressed. JCVI 2023. To learn more, visit the Vaccine Knowledge project
UK Routine Immunisation Programme
In the UK, the Varicella (chickenpox) vaccine isn’t part of the routine childhood immunisation schedule — although it is available privately and is offered on the NHS in specific cases, such as:
- For close contacts of someone who is vulnerable to severe chickenpox (e.g. someone undergoing chemotherapy)
- Healthcare workers who haven’t had chickenpox before
Why does the UK not have a childhood vaccination programme when many other countries do?
In 2009 the JCVI expressed concern that if children are routinely vaccinated, fewer people would catch it as kids and more would get it later in life, when it can be more dangerous.
There was also concern that fewer childhood infections could increase shingles (Herpes Zoster) cases in older adults. This is because exposure to chickenpox in the community seems to boost immunity to shingles — a phenomenon called exogenous boosting.
Updated evidence
Countries such as the US and Germany, that have introduced programmes have observed significant impact on cases of varicella and resulting hospitalisations. As has been shown in other countries which include varicella in their routine vaccination schedule the recommendation to add a 2-dose schedule in the UK is predicted to decrease the number of cases of varicella seen in childhood rapidly and dramatically. Thereby reducing the cost and burden of disease on the UK health service.
The JCVI reviewed data published from studies in the USA and concluded that this data does not support predictions that the varicella vaccination programme would increase herpes zoster incidence.
For more details on the JCVI previous considerations and updated recommendations you can read the JCVI statement on a childhood varicella (chickenpox) vaccination programme here.
The introduction of a UK vaccination programme: January 2026.
What Changes Are Being Proposed by the JCVI?
Subject to a final policy decision, a routine Varicella (chickenpox) vaccination programme is under consideration to launch from the 1st January 2026.
Why the recommended change?
- Evidence from other countries: Many other countries, have successfully introduced the varicella vaccination into their vaccination programmes, leading to sharp declines in hospitalisations and severe cases of chickenpox
- Cost-effectiveness: The introduction of a routine varicella vaccine reduces the economic burden of GP visits, hospital admissions and missed workdays caused by chickenpox outbreaks.
- Reducing burden of disease: Chickenpox is highly contagious and can cause severe complications, especially in immunocompromised children and pregnant women.
- Herd immunity loss post-lockdown: COVID-19 restrictions reduced population exposure to varicella, particularly in older children who missed natural infection. With immunity gaps widening, this cohort is now more vulnerable – and chickenpox tends to be more severe with age.
When and how will the Change Work in Practice?
- 1st January 2026, children turning 12 months will receive two doses of MMRV (Measles, Mumps, Rubella, Varicella) at 12 and 18 months.
- Children turning 18 months on or after that date will receive a single MMRV to complete the new schedule.
- Children aged 18 months to 3 years 4 months on 1st January 2026 will be invited for one MMRV dose instead of their second MMR, with catch-up completed by 31st October 2026.
- Children aged 3 years 4 months to under 6 years will be offered a single universal MMRV catch-up dose by 31st March 2027.
- Children aged 6 to under 11 years with no chickenpox history will be invited for a single MMRV dose, also to be completed by 31st March 2027.
- 1st April 2027, opportunistic or on-request single-dose offers will be available for unvaccinated children aged 3 years 4 months to under 11 years with no chickenpox history.
Vaccine to be used
Varicella vaccination is available as a varicella-only product, or as a combination with measles, mumps and rubella (MMR), as MMRV.
Using a combined vaccine for both the first and second dose would mean that fewer injections would need to be given in a single immunisation visit. Previous attitudinal work has suggested that having fewer injections is preferred among parents, and a recent study among UK parents indicated that a combined varicella vaccine was preferred to separate vaccines. JCVI 2023
‘It is the view of the committee that both doses given in the varicella programme should be as the combined MMRV vaccine.’
The changes to the UK Vaccination programme are still subject to a final policy decision.
It is recommended that those delivering or advising on the UK vaccination programmes keep themselves updated with the potential changes.
You can do so by subscribing to UKHSA Vaccine update. A regular newsletter published online.
To subscribe click on the following link : Subscribe to vaccine update here
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