Latest Guidance from the Department for Education (DfE) and UK Health Security Agency (UKHSA) regarding breakthrough varicella (chickenpox in vaccinated individuals) and school attendance:

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🧬 Breakthrough Varicella Overview

• Definition: Breakthrough varicella is chickenpox occurring in a person more than 42 days after vaccination.
• Symptoms: Typically milder than in unvaccinated individuals:
  • Fewer than 50 lesions
  • Often maculopapular rather than vesicular
  • Low or no fever
  • Shorter illness duration
• Diagnosis: PCR testing of skin lesions is the most accurate method, especially since the rash may resemble other conditions like insect bites or ringworm

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🏫 School Attendance Guidance (DfE & UKHSA)

✅ When to Exclude a Child

• Children with breakthrough chickenpox should still be excluded from school.
• Exclusion lasts until all lesions have crusted, or if no vesicles are present, until no new lesions appear for 24 hours
• This applies even if the child is vaccinated, as they are still infectious.

✅ When to Return

• Once lesions have crusted or no new lesions have appeared for 24 hours, the child can return to school.
• Lesions do not need to be completely gone, especially in vaccinated children where crusting may not occur.

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  Chickenpox - NHS

Chickenpox is a common infection that spreads easily and mostly affects children. It usually gets better on its own after 1 to 2 weeks without needing to see a GP, but can be serious in some people.

Chickenpox Symptoms

The main symptom of chickenpox is an itchy, spotty rash. It can be anywhere on the body. Before or after the rash appears, you might also have a high temperature, aches and pains, and generally feeling unwell, loss of appetite.

Chickenpox happens in 3 stages, but new spots can appear while others are becoming blisters or forming a scab.

Stage 1: Small spots appear: The spots can be anywhere on the body, including inside the mouth and around the genitals, which can be painful, spread or stay in a small area, be red, pink, darker or the same colour as surrounding skin, depending on your skin tone, be harder to see on brown and black skin

Stage 2: the spots become blisters: The spots fill with fluid and become blisters. The blisters are very itchy and may burst.

Stage 3: the blisters become scabs: The spots form a scab. Some scabs are flaky, while others leak fluid.

When to Exclude a Child or Adult

If you have chickenpox, you'll need to stay off school, nursery or work until all the spots have formed a scab. This is usually 5 days after the spots first appeared. 

https://www.nhs.uk/conditions/chickenpox/