Help with vaccines for school please...

  1. Hello everyone and thanks in advance...

    i have about 45 days to get my vaccines together but am confused on the info in regards to the 2 step PPD and MMR plus Virucella vaccines being administered together..online people say you can't and the clinic I'm going to is saying I can do them at the same time but from reading online it says that if you take MMR or Virucella with the first PPD the results could be false and you will have to wait for like 30 days before you can do the PPD again which I can't afford to mess up on.

    Here is what I need.

    2 step PPD
    MMR
    Virucella
    Hep B
    Tdap
    Hep C? I don't even know why they have this listed..

    What should I do it's driving me crazy no on has a answer for me so that's why I joined the sight and hopefully the knowledge on this forum can help me out...

    Scenarios:

    1. I take 2 step PPD, MMR, Virucella, Hep B, Tdap all in one day as my clinic is saying to do and their will be no problems or...should I?

    2. Take 2 step PPD wait the week get the second....then get 1st set of MMR, Virucella together and then wait 28 days for the second sets of these?

    Also if anyone can let me know where and when I can squeeze in the Tdap, and Hep B. Can I do these if I go with scenario 2 can I do them with the 2 step PPD or do them with MMR and Virucella; will they interfere with MMR, or Virucella? I'm kind of lost hope I am clear in what I am asking here...

    Thank you to anyone who has read my thread in its entirety to help me out...please help...������������
    Last edit by Bo3939 on Jun 17 : Reason: Change how to be updated
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  2. 25 Comments

  3. by   centercourt2015
    Easy. Forget the PPD and get a Quantiferon Gold blood test (TB testing). The hospital I work for doesn't even do PPD's anymore. All healthcare workers need to do Quantiferon.

    From the CDC:
    "The greater specificity of the Quantiferon test and the requirement for only one visit are compelling advantages."


    QuantiFERON -TB Gold In-Tube Test : QuantiFERON(R)-TB Gold
  4. by   Bo3939
    Thanks for the quick response but this is for a school and it is mandatory....please let me know which scenario I could go with and when it will be safe to squeeze in the Tdap and Hep B to not interfere with results if that makes sense thank you kindly..
  5. by   Bo3939
    Immunization: You Call the Shots

    Check that out and I also have heard people run into the MMR and 2 step problem...
  6. by   centercourt2015
    I see no reason why your school would not take the results of a Quantiferon test which is more accurate. I'm in nursing school and they took mine. If you're short on time then that would be your best bet. The cost is the only reason people would do a PPD vs Quantiferon.

    Anyways, According to the state of Oregon Public Health, you can do the PPD as long as you do them at the same time as the MMR and Varicella. (http://www.oregon.gov/oha/ph/Prevent...ents/SOTST.pdf). This is what I found, I don't see why the clinic would lie to you about your concerns.

    I would still do call your school and see if you can do the quantiferon instead.

    Also, do you know if you have had the BCG vaccine in the past? If so, your PPD will be positive for sure.
    Last edit by centercourt2015 on Jun 17
  7. by   Bo3939
    They just don't allow it at my school...I read here on this forum where someone took the MMR with the 2 step and the second step which was a week later came false positive and they had to wait 4-6 weeks before they could do the 2 step which was longer then they had to get them done...

    You think I should just get the 2 step started asap Monday wait the week get the second and then like the day after start the MMR and Virucella which are 28 days apart so that would bring me to about 40 days sparing me 5 five days to get all this done...one more question when can I take the hep B and Tdap?? I've read I can go ahead and take the Hep B with the 2 step PPD thanks...

    If anyone else can please help that would be great thanks everyone..
  8. by   JustBeachyNurse
    There is no vaccine for HepC only HeoA and HepB
  9. by   Bo3939
    Yeah i know I don't even know why that is on there too...

    But can you please read my first post and advise on which scenario to go with and how to squeeze in the Tdap and Hep B please...thank you.
  10. by   centercourt2015
    This is not to sound insensitive, but were you raised in the United States (went to grade school in the US)? If so, then you most likely would have gotten the hep B series done and you probably just need titters to prove your immunity or a booster (if you had it before but titers show up as negative).

    Also, if you've had chickenpox before then you probably don't need the varicella vaccine and just need titers to prove immunity.
  11. by   JustBeachyNurse
    Quote from Bo3939
    Yeah i know I don't even know why that is on there too...

    But can you please read my first post and advise on which scenario to go with and how to squeeze in the Tdap and Hep B please...thank you.

    Check with your county health department the public health nurses will know the current protocol. Last I read it was you could do the ppd before the live vaccines or with the live vaccines (MMR, Varicella)

    MMR can be administered same day as PPD but not after PPD according to the CDC evidence based practices (see table #4)
    Source: General Recommendations on Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Family Physicians (AAFP)
  12. by   JustBeachyNurse
    Tuberculin Skin Test
    Infants and children who need a tuberculin skin test (TST) can and should be immunized. All vaccines, including MMR, can be given on the same day as a TST, or any time after
    a TST is applied. For most vaccines, there are no TST
    timing restrictions.
    MMR vaccine may decrease the response to a TST, potentially causing a false-negative response in someone who actually has an infection with tuberculosis. MMR can be given the same day as a TST, but if MMR has been given and 1 or more days have elapsed, in most situations a wait of at least 4 weeks is recommended before giving a routine TST. No information on the effect of varicella-containing vaccine or LAIV on a TST is available. Until such information is available, it is prudent to apply rules for spacing measles vaccine and TST to varicella-containing vaccine and LAIV.
    There is a type of tuberculosis test known as an interferon- gamma release assay (IGRA). Even though this test improves upon the TST because it is less affected by previous doses
    of BCG vaccine and less affected by previous doses of tuberculosis diagnostic testing, it still may be affected by previous doses of other live vaccines so it is prudent to apply the same spacing rules as for TST
    Source: https://www.cdc.gov/vaccines/pubs/pi...ads/genrec.pdf

    This document from the CDC should answer all your questions regarding PPD and spacing vaccines based on current recommendations
  13. by   Bo3939
    Sounds insensitive but it's cool and yes to your questions...you could have just politely asked if I revived my Hep B and that I would need proof for my titers...yes I had chicken pox thanks for the advice buddy take care I was just looking for a simple answer to the scenarios not the run around and oh I'm not trying to be insensitive.
    Last edit by Bo3939 on Jun 18 : Reason: Typo
  14. by   Bo3939
    Thanks for your great answers, I actually just got off the phone with a nurse who is a friend and a neighbor and she was kind of unaware of the MMR and Virucella being taken with the PPD but also said they can may be done together so that's why I also wanted to check here and it is the reason I am confused about this cause...the clinic I spoke with today also said I can do them at the same time I will probably just wait since I have a little time I guess just to be safe and not have to wait a additional four weeks to do PPD which will not work for me...

    So I am doing the PPD tomorrow since I will not do the Virucella and MMR since a false neg could pop up since people have actually had this happen when taken together..do you know if it will be ok to at least get the Hep B rolling and Tdap done tomorrow with the 1st PPD...cause I would love to get those done if I can...

    Thanks for being a good impression of this website!

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Help with vaccines for school please...