Pertussis Titer instead of vaccination?

Nurses General Nursing

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I was wondering if anyone has had a pertussis titer drawn before to see if the TdaP was even necessary. I know more facilities are requiring the pertussis vaccination. We can submit titers for Hep B, MMR, and Varicella, but why not pertussis? If you have done it and paid for it out of pocket, how much did it cost? Thanks for any insight you have!

If paying for the titer is not an issue for you then just get it done. If they accept the results you have (if immune), good, if they don't then be prepared to either get the vaccine or lose a job opportunity. Simple as that isn't it?

Find your records of the 3-part series. Otherwise, the burden of proof is on you and if you can't prove it, get the 3-part series unless you are confident that a (+) titer group will prove immunity to all 3 (Tetorifice, diptheria, and acellular pertussis ="Tdap").

http://www.immunize.org/catg.d/p2011.pdf

"On October 26, 2005, ACIP voted to recommend routine use of Tdap among adults aged 19 - 64 years," write Katrina Kretsinger, MD, from the Division of Bacterial Diseases of the US Centers for Disease Control and Prevention (CDC) and colleagues from the Healthcare Infection Control Practices Advisory Committee (HICPAC). "For adult contacts of infants, ACIP recommended Tdap at an interval as short as 2 years since the previous Td [tetorifice and diphtheria toxoids vaccine]. On February 22, 2006, ACIP recommended Tdap for health-care personnel (HCP), also at an interval as short as 2 years since the last Td."

http://www.medscape.org/viewarticle/550117

Log all of your vaccinations into your WHO card and also your Google Health profile (so you can reference anywhere, anytime, regardless of whether your WHO card gets lost or not). http://health.google.com. If you live in California, ask if they can load all of your vaccines into the California Immunization Registry (CAIR), which is supposed to cut down on redundancies and calculate reminders for vacs that are expiring & coming due. I have some scanned .pdf files of my latest CAIR printout and my WHO card as well as my military shot record attached inside my GoogleHealth database. I wouldn't put anything sensitive (of interest to insurance companies or scammers) into GoogleHealth, but I put positive stuff in there which doesn't have SSN or my full legal name. As nurses we are expected to be vaccinated/immune to all of these diseases, and are called upon to prove current status at any time. Having these records in order and accessible at any time is a must.

Also check the CDC and other organizations to make sure you are with the guidelines for healthcare providers. This way you can prevent unfinished series leading to a bunch of redundant or unnecessary vaccinations. For a regular civilian, it's easy to refuse all vaccinations. For nurses looking for employment, it might be easier to just make sure that you are eliminating the preventable vacs while getting the ones that protect you and your patients from these diseases, especially children and those who are most vulnerable.

That's my take on the matter. I found a bunch of fumbled series for HepB, MMR, Tdap, Anthrax, etc in my military records. Evidently, they didn't care about lifetime immunity, so long as I was covered while at each specific command/unit. The next unit would also give me the first shot and usually leave it at that.

It was up to me to get each series finished but I was young, busy, and ignorant of the series regimes, and thought someone would follow up with me whenever I needed more vaccines. It turns out that it's up to us to manage this stuff. Even my current doctor doesn't notice or care that I need certain vaccines; I have to ask for them. For Tdap I think it makes sense to get 3 in series and then 1 every ten years rather than one booster every 1-2 years. The way it works currently, if you lost your childhood records, it's assumed that you are just in for the booster, and without any proof of the initial series in the record, that booster comes due every year or two (depending on what your source is). It just pops up on the computer screen that it's due. Many people don't have their childhood records so it's hard to prove you've had these shots. Somebody must be making a fortune on all of these extra vaccinations.

I have CAIR and google health printouts that I supply to every HCP and employer I make contact with. That way nobody sends me out to get a shot that I have already gotten or don't need. Titers are also handy in many circumstances but like previous posters have said, you can't be sure what an employer might demand. If you are asked for a (+) titer result you may not be able to complete an entire series AND a titer in time to qualify for that position. I almost lost my clinical placement in nursing school because I had low immunity to Mumps despite having the complete series a long while back but within guidelines (that or, the titer was flawed). What I should have done is pay for a confirmatory titer just prior to nursing school, to make sure my series was still giving me ample immunity. INSTEAD, I had to rush all over town getting every shot and titer I could pay for (I spent a small fortune), hoping one place would get results back ASAP so I could convene clinicals. Meanwhile I should have been studying- it was very, very stressful, and one titer came back (luckily +) at the very last minute (The rest would have been too late). If that were a job, I could have been passed over. I very well could have lost my seat in that nursing program over that mistake. Personally I think you should get all recommended vacs (no more, no less) AND confirm them with a titer.

Employers love getting a neat list of vaccines and titer results, with dates, signed by a clinician, showing that you are totally covered and ready to go to work anywhere. I'm sure patients wouldn't mind knowing that you are completely vaccinated/immune, either.

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