Help with vaccines for school please...

OliverElio87, BSN, RN · Jun 18, 2017

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®-TB Gold

Bo3939 · Jun 18, 2017

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..

Bo3939 · Jun 18, 2017

Immunization: You Call the Shots

Check that out and I also have heard people run into the MMR and 2 step problem...

OliverElio87, BSN, RN · Jun 18, 2017

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/PreventionWellness/VaccinesImmunization/ImmunizationProviderResources/Documents/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.

Bo3939 · Jun 18, 2017

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..

JustBeachyNurse, LPN · Jun 18, 2017

There is no vaccine for HepC only HeoA and HepB

Bo3939 · Jun 18, 2017

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.

OliverElio87, BSN, RN · Jun 18, 2017

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.

JustBeachyNurse, LPN · Jun 18, 2017

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)

JustBeachyNurse, LPN · Jun 18, 2017

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/pinkbook/downloads/genrec.pdf

This document from the CDC should answer all your questions regarding PPD and spacing vaccines based on current recommendations

Bo3939 · Jun 18, 2017

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.