immunization requirements- 2-step PPD


It's required that I get a 2-step PPD before I start clinicals this fall. My doctor has never heard of it before; the nurse I explained it to looked at me as though I was crazy, because apparently she never heard of it too.

Can any of you please clarify what this 2-step PPD is and how it is done? I am confused...:uhoh21:



Has 10 years experience. 48 Posts

I was curious, did a search, and found this online. Hope it helps.


1. The two step PPD skin test requires

a Administration of a PPD skin test which is read within 48-72 hours;

b. If the reaction to the first PPD skin test is classified as negative, a second test should be done within 1 to 3 weeks of the first test;

c. If the reaction to the first PPD skin test is classified as positive, the person is considered infected and a second skin test is not done

d. A positive reaction to the second test is classified as a "boosted" reaction.


klone, MSN, RN

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership. Has 16 years experience. 14,248 Posts

What is it? Is it a TB test?


wonderbee, BSN, RN

Specializes in critical care; community health; psych. 1 Article; 2,212 Posts

I had to have the two-step PPD for work. School was not as particular and only required the one-step.

Yes, It's the TB test.

Just found out that my series of Hep B which I completed a couple of months ago was for nothing. I didn't sero convert. Dang, I have to have the whole series over again.

That's another difference I noticed. For school, I was required to have the Hep B series and that was the end of that. Work required the same thing however they tested me to see whether I really built up an immunity following the series. It appears I did not. Just goes to show you that just because you get an immunization, it doesn't mean you're immunized.


jschut, BSN, RN

Has 20 years experience. 2,743 Posts

I had to have all of the titers drawn to see if I was covered by my childhood immunizations...apparently I was, cause everything came back ok.

I still have to finish my HepB series in September, then I'll be complete.

Altra, BSN, RN

Specializes in Emergency & Trauma/Adult ICU. 6,255 Posts

My school requires the 2-step once, then the 1-step annually. It is provided for us (as was the HepB series) at no cost through the Employee Health dept. of the hospital.


purplemania, BSN, RN

2,617 Posts

PPD stands for purified protein derivitive, but is called a TB skin test most of the time. Another name is Mantoux, but who cares? The CDC recommends the two-step process in order to establish a baseline. KEEP your documentation on all immunizations. Do not depend on someone else to do this.



154 Posts

I had my Hep B series years ago, along with the rest of our volunteer fire/rescuse squad. But I do know of at least one person who never did sero convert....they finally gave up after doing the series twice.

Anyone have any clue why someone wouldn't sero convert?


This topic is now closed to further replies.