The Hawaii Department of Health (DOH) has reported an increase in chickenpox cases on Kauaʻi, with the total now reaching 10. The cases are linked to four schools: Kīlauea Elementary School, Hanalei Elementary School, Kauaʻi Christian Academy, and Island School. All affected individuals are children under 18 years old. Of these, one child was partially vaccinated and experienced a milder illness; the remaining nine were unvaccinated.
The DOH Disease Investigation Branch is urging families and schools to take steps to prevent further spread of the disease. According to the DOH, “Community members who have not previously been infected with or fully vaccinated against chickenpox are at risk of infection, but can protect themselves and others by getting chickenpox vaccine now. Some individuals cannot be vaccinated and may be at risk of severe disease if exposed and they are not already immune — especially pregnant women, newborns and those with medical conditions that weaken their immune system. These individuals or their caregivers should seek medical advice to learn about other medications they can take for protection.”
Many schools on Kauaʻi have low vaccination rates among students. The DOH recommends that eligible individuals receive two doses of the varicella vaccine for nearly complete immunity or reduced severity if infected. Children typically receive one dose between 12-15 months of age and a second dose between ages 4-6 years. During outbreaks, an accelerated schedule is recommended for adults and children over one year old.
Groups at highest risk include non-immune adolescents, adults, pregnant women, people with weakened immune systems, and infants under one year old (who are not eligible for vaccination). Household members of infants should check their own immunity status.
The DOH also advises: “If you can’t get the vaccine for medical reasons, talk to your doctor immediately: If you are not protected against chickenpox (did not previously have infection or vaccination), seek medical advice about the best options for protection. Especially vulnerable are pregnant women, newborns and those with weakened immune systems.”
To reduce transmission, anyone showing symptoms such as rash or blisters should stay home until all blisters form scabs—usually five to seven days after onset—and avoid contact with others during this period.
The department cautions against intentional exposure through “chickenpox parties,” stating: “Trying to achieve immunity through deliberate exposure to chickenpox can cause unnecessary suffering by the child, increase the child’s lifetime risk of shingles, and make someone in vulnerable health who gets exposed seriously ill. Two doses of vaccine provide lifelong protection for most people and reduce the risk of contracting shingles.”
Since January 23rd when the outbreak began, health officials have worked with affected schools and communities while expanding access to vaccines. However, they have decided not to require non-immune but healthy children exposed to chickenpox to stay home from school due to concerns about prolonged absences and community spread outside school settings.
Varicella vaccine is available at most doctors’ offices and some pharmacies; residents are encouraged to call ahead before visiting. The Kauaʻi District Health Office plans a free community vaccine clinic soon.
Chickenpox is caused by the varicella-zoster virus (VZV) and spreads easily through respiratory droplets or direct contact with blisters. It typically presents after a two-week incubation period as an itchy rash that turns into fluid-filled blisters.
The Hawaii State Department of Health works statewide through its Disease Outbreak Control Division promoting health education on vaccination https://health.hawaii.gov/. Its programs aim to improve public health conditions across Hawaii’s islands https://health.hawaii.gov/, coordinated by a director supported by deputy directors https://health.hawaii.gov/. The department’s Office of Public Health Preparedness leads planning for epidemics like this outbreak https://health.hawaii.gov/.
More information is available on the DOH varicella website or CDC vaccination pages.
