Hep B vaccine schedule question...I screwed up.

Published

I'm begining Junior year of my BSN program and clinicals will begin right away.

I have had some confusion before about my health form, specifically the Hep B vaccine series. My school wants proof of vaccine AND "seriologic evidence of immunity/titer". I have no records that I could find of any Hep B vaccine so my current doctor's office and I decided to just start the series. The rep from my school was annoyed because she thought I should have just gotten the titer to see if I had immunity. She really gave me a hard time and finally we agreed that it was more likely I never had it. On 9/15/15 I had shot #1 exactly one month later I had shot #2 like Instructed, then I was supposed to get shot #3 "5 months" later BUT it's now 10 months later and I'm getting it on Friday. (Long story about my pcp leaving his practice, communication mishaps with his office staff about scheduling and me losing my Medicaid). Yes lots of excuses I know but this is where I'm at.

With all that being said, my question is this, does anyone know if the general requirement regarding the vaccine schedule is that it must be exactly 5 month later for the last shot or can it be any time after 5 months...or approximately 5 months? Is the important part that I show enough immunity by the time a get the "serological evidence of immunity" test a month after the final shot?

Im so stressed and will not be able to speak to the woman at my school until the semester begins. Thank you in advance.

Up Vote Up Vote ×

I believe this violates the TOS regarding offering medical advice on this forum. I would discuss this with my doctor and with the lab coordinator at my school if it were me. Every school is different.

Up Vote Up Vote ×
I believe this violates the TOS regarding offering medical advice on this forum. I would discuss this with my doctor and with the lab coordinator at my school if it were me. Every school is different.

No, no actually it does not. My question is about school/clinical policy. My question is if anyone has knowledge about what clinical sites want from me or if they experienced being held back a semester because they don't have the vaccines given exactly they way they are listed on the guideline.

Up Vote Up Vote ×
I believe this violates the TOS regarding offering medical advice on this forum. I would discuss this with my doctor and with the lab coordinator at my school if it were me. Every school is different.

I was simply giving background on the situation so people wouldn't tell me to "just go talk to the school." Obviously every school is different, I specifically stated I can't get in touch with the person I need to speak to yet and I am asking if anyone else has been in a similar situation and can tell me their outcome.

Up Vote Up Vote ×
Specializes in Complex pedi to LTC/SA & now a manager.

Always know the resources. For vaccines it's the CDC and they always address late or incomplete series and the protocol because it happens.

[h=4]Is it harmful to have an extra dose of Hepatitis B vaccine or to repeat the entire Hepatitis B vaccine series?[/h]No, getting extra doses of Hepatitis B vaccine is not harmful.

What should be done if Hepatitis B vaccine series was not completed?

Talk to your health professional to resume the vaccine series as soon as possible. The series does not need to be restarted.

source: Hepatitis B FAQs for the Public | Division of Viral Hepatitis | CDC

FYI--the cdc maintains information pages for all mandated, recommended and special vaccines (like anthrax & yellow fever)

Up Vote Up Vote ×
Always know the resources. For vaccines it's the CDC and they always address late or incomplete series and the protocol because it happens.

source: Hepatitis B FAQs for the Public | Division of Viral Hepatitis | CDC

FYI--the cdc maintains information pages for all mandated, recommended and special vaccines (like anthrax & yellow fever)

Thank you! I know the guidelines state you don't have to repeat the series but I found out it does have to be repeated if I have a titer that shows low immunity. My concern is does the extra 5 months contribute to low immunity or is it usually enough to not be an issue?

Up Vote Up Vote ×

When you receive the final dose, you will have completed the series. That should satisfy the school's requirement. As to displaying "serological evidence of immunity," the only way you will know is to finish the series and have your titer drawn. Although most show an appropriate response after completing the series, not all do. When I completed the series, as scheduled, I required a fourth dose. One of the practitioners I work with has completed the series twice, and still doesn't have an appropriate titer.

Up Vote Up Vote ×
When you receive the final dose, you will have completed the series. That should satisfy the school's requirement. As to displaying "serological evidence of immunity," the only way you will know is to finish the series and have your titer drawn. Although most show an appropriate response after completing the series, not all do. When I completed the series, as scheduled, I required a fourth dose. One of the practitioners I work with has completed the series twice, and still doesn't have an appropriate titer.

Oh my, that is what I was afraid of. I just hope it's enough because I'm worried they will not allow me to start clinicals and I will have to repeat a semester or have it impact my grade in some way. Thank you for that information!

Up Vote Up Vote ×
Specializes in Med Surg, PCU, Travel.

FYI many Hep B titers produce false negative results so don't waste you time. Did my research on that after I paid for the titer (being former EMT) cause i knew I had it done. End up retaking the series. Consult your school/ MD about other questions. Most schools I know of, accept you as long as you started the series. Some schools have a wavier you could sign to refuse to take it.

Up Vote Up Vote ×
Specializes in Emergency.

I guess I'm just confused why you didn't just get your titers checked instead first? If you go to an in house lab, you would get your titers back pretty much same day.

Up Vote Up Vote ×

I am not sure about other schools, but mine lets us go to clinical as long as we have started the series. We just have to sign a form stating that the school isn't liable if we get sick and get the vaccines/titers taken care of asap.

Up Vote Up Vote ×
I guess I'm just confused why you didn't just get your titers checked instead first? If you go to an in house lab, you would get your titers back pretty much same day.

That is the argument the school coordinator made. I get it, and at first I agreed but in the process of receiving multiple vaccines, and sorting through my medical documents and needing to go to Labcorp for all the blood work--my doctors office determined that it was highly unlikely that I never received a Hep B vaccine in the first place due to my age, no sign of it in my med history and other factors, including have no idea if I ever received the vaccine. They reccomended to proceed with the vaccine series to get it started so I could get my medical documents in. (My insurance doesn't allow for any in house lab work, I must go to Labcorp which would add even more of a delay.)

Up Vote Up Vote ×
+ Join the Discussion