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Vaccines for All Who Have Not Had Chicken Pox Advocated

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The approval of the first-ever vaccine for chicken pox has spurred pediatricians and children's-health experts to sort out who should receive the drug and at what age.

Everyone older than age 1 who has not had chicken pox should receive the vaccine, according to draft recommendations from the American Academy of Pediatrics and a group advising the federal government.

It is unclear, however, whether or when states might begin to require children to have the vaccine before they can enroll in school, day care, or Head Start.

The vaccine could end the lengthy school absences caused by the highly contagious viral disease, which is characterized by itchy skin eruptions. It won approval from the U.S. Food and Drug Administration this month, and is expected to be widely available in about two months.

However, there is no urgent need to have children immunized immediately, said Dr. Steve Kohl, the chief of pediatric infectious diseases at the University of California at San Francisco.

"It's not something where we're going to set up emergency vaccination booths or anything like that," said Dr. Kohl, who is a member of the A.A.P.'s committee on infectious diseases, which drafted the recommendations.

In the May issue of the journal Pediatrics, the A.A.P. plans to recommend that children from 12 to 18 months who have not had chicken pox be given the vaccine when they receive the standard measles-mumps-rubella immunization. In addition, older children who have not already been immunized or who have not had chicken pox should be vaccinated.

Age Differences

Dr. Kohl said that for the older children, the vaccination "should be done in a timely fashion convenient to both physician and patient."

But the academy wants children to get the chicken-pox vaccine before their 13th birthdays, Dr. Kohl said, because only one dose of the vaccine is needed up to that point. After age 13 and through adulthood, two doses are needed to provide protection.

While the federal Centers for Disease Control and Prevention's advisory committee on immunization practices will issue separate recommendations, Dr. Kohl said the groups agree on this issue so far.

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