Question about chickenpox vaccine

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Specializes in Telemetry.

Hello everyone,

I am a first semester nursing student, I'm taking Fundamentals and in two weeks we start our clinic rotation at the hospital.

Today I was informed by my CI that I might not be able to continue the semester and I might be asked to step out of the class.

The problem is my chickenpox titers. I never had chickenpox and I got my two shot series vaccine more than two months ago. When I got my titers about three weeks ago, they came back as equivocal.

When I spoke with my CI about this she said not to worry about it since I had the vaccine done. Now she is saying that I need my titers to be positive if I want to be allowed to go to clinicals. I just got my titers re-done again today and now I'm here praying and keeping my fingers crossed.

I am very mad because I was told that it was not a problem, and also because I did everything that I was supposed to do in a timely manner (I got my second shot back in January).

Today I was talking to the NP at the clinic and she said that it would be very silly if they won't allow me to finish the semester because some people simply don't convert the vaccine or have a weaker response than others.

I was wondering what the policy at your school is about titers. I'm doing some research in case my titers come back equivocal again. I feel like there is nothing else that I could have done differently. It's very frustrating because I waited two years to get in the program and I'm doing really well in my class.

Any advice would be greatly appreciated.

Thank you for reading this far.

Daniela

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Specializes in ED, ICU, PACU.

There is another way to take titers that is costly and was told it is 'the gold standard.' I never had chicken pox but was exposed to it numerous times, in close relatives. Although the standard titer came back negative, I was considered too old to receive the vaccine safely (according to employee health). The hospital paid for this 'gold standard' test which revealed a natural immunity, which is not detectable on the normal antibody test (which only reveals acquired immunity). If you have a natural immunity, then you would not have to build the antibodies tested for in the cheaper, standard test because you already have a different antibody warding off the infection. You could ask the school to test you with better test, rather than letting you go because they are too cheap to do the proper test for your situation.

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My school you have to have positive titers no matter what. But the previous poster has a great idea. I would look into that.

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Specializes in Telemetry.

Thank you this is great advice! I was not aware of this option. I'm afraid I won't have enough time though since clinicals are starting in two weeks and my school is on spring break next week.

The thing is that I may not have positive titers ever, so I've been told. I got my vaccine more than two months ago and by now I should have built up immunity and I did from 0.90 my titers went up to 0.96 but I need a 1.1 to be considered positive.

I am really crying my eyes out because I can believe that I might have to step out of the semester for this. I just don't think it's fair.

Thanks again.

Daniela

There is another way to take titers that is costly and was told it is 'the gold standard.' I never had chicken pox but was exposed to it numerous times, in close relatives. Although the standard titer came back negative, I was considered too old to receive the vaccine safely (according to employee health). The hospital paid for this 'gold standard' test which revealed a natural immunity, which is not detectable on the normal antibody test (which only reveals acquired immunity). If you have a natural immunity, then you would not have to build the antibodies tested for in the cheaper, standard test because you already have a different antibody warding off the infection. You could ask the school to test you with better test, rather than letting you go because they are too cheap to do the proper test for your situation.
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Specializes in Telemetry.

So it looks like my nursing student career ends here. I won't be allowed to go to clinicals because I didn't develop immunity after receiving the chickenpox vaccine. I am very sad and still can't believe this is happening.

I did everything my school required (getting the vaccine) and unfortunately my body didn't convert. I feel it's not really fair but I am tired of fighting. Apparently I can't be a nurse because of this and according to my school there is nothing they can do.

Today I will try to speak with the director of my nursing program to see if there is another hospital with a different policy where I can go for my clinicals. This is my last hope.

I just feel so sad and needed to share this! :cry:

Daniela

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Wow... I am so sorry to hear this! I like you was equivocal. I had chicken pox as a child and have been exposed to them many times over the years and never caught them again. I have had the series of two shots and am waiting to have the titer re done. Now I am very scared that mine too will not come back positive :( I hope there is something else you can do to remain in the program. Please keep us updated :)

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Specializes in Telemetry.

Thank you for your words. Today I got my second titers results back and I went from equivocal to negative :cry:. I did speak with the director of my nursing program and she was very sweet (the whole time I was talking to her I was crying :(). She told me that she is going to see if one of the other two hospitals will take me. I have my immunization card with proof of immunization and she said that some hospital are ok with that.

I just have to wait, hope and keep my fingers crossed. I can't believe my future depends on this.

I'm sure your titers will come back positive. I have been told that only a small percentage of the population doesn't convert.

Daniela

Wow... I am so sorry to hear this! I like you was equivocal. I had chicken pox as a child and have been exposed to them many times over the years and never caught them again. I have had the series of two shots and am waiting to have the titer re done. Now I am very scared that mine too will not come back positive :( I hope there is something else you can do to remain in the program. Please keep us updated :)
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Specializes in Telemetry.

I finally heard back from the hospital I will be doing my clinicals for first semester and they told me that they will allow me to go there because I have proof of vaccination. I am so happy and can finally breathe a sigh of relief :bugeyes:

They asked me to repeat the chickenpox vaccine during the summer to see if I develop immunity this time. My nursing program director also told me that I might have big problems when we do our Peds rotation in third semester if I don't develop immunity.

Did anyone of you have this problem or know of anyone who had this problem? I'm willing to repeat the vaccine and I will but I'm just wondering what will happen if I still don't develop immunity? Will my dream of being a nurse end because of this? Is it possible that I can't be a nurse simply because my immune system doesn't produce antibodies for chickenpox?

Any suggestions or advice will be appreciated!

Thanks.

Daniela

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have you looked into the more sensitive/different testing mentioned earlier in the thread? now that you have time, i would think this would be a good idea....good luck

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Specializes in ED, ICU, PACU.

Did anyone of you have this problem or know of anyone who had this problem? I'm willing to repeat the vaccine and I will but I'm just wondering what will happen if I still don't develop immunity? Will my dream of being a nurse end because of this? Is it possible that I can't be a nurse simply because my immune system doesn't produce antibodies for chickenpox?

Any suggestions or advice will be appreciated!

Thanks.

Daniela

I can't develop detectable immunity to the standard test for aquired immunity from having chicken pox or the chicken pox vaccine because I have a natural immunity, that is only detectable with that 'gold standard' test I mentioned about earlier on. The immune system does have antibodies with a natural immunity, just not the type that are made after exposure to the disease-it just takes a different type of test to look for the natural immunity antibodies. I still say to insist on that more expensive test.

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Specializes in Telemetry.

Hi there,

thank you again for your advice. I see that you're a nurse and this gives me hope!!!! Did you have to get this special test when you were in nursing school?

I will be repeating the chickenpox vaccine in the summer and see if I develop immunity this time, but I'm doing some research about the test you mentioned. Does it have a particular name? Do I have to go to a specialized lab to get this done? I'm sorry for all these questions but I don't seem to find anything online. I'm willing to do everything that I can (even if it's expensive) because I want to be a nurse!!!!

Daniela

I can't develop detectable immunity to the standard test for aquired immunity from having chicken pox or the chicken pox vaccine because I have a natural immunity, that is only detectable with that 'gold standard' test I mentioned about earlier on. The immune system does have antibodies with a natural immunity, just not the type that are made after exposure to the disease-it just takes a different type of test to look for the natural immunity antibodies. I still say to insist on that more expensive test.
Up Vote Up Vote ×
Specializes in ED, ICU, PACU.
Hi there,

thank you again for your advice. I see that you're a nurse and this gives me hope!!!! Did you have to get this special test when you were in nursing school?

I will be repeating the chickenpox vaccine in the summer and see if I develop immunity this time, but I'm doing some research about the test you mentioned. Does it have a particular name? Do I have to go to a specialized lab to get this done? I'm sorry for all these questions but I don't seem to find anything online. I'm willing to do everything that I can (even if it's expensive) because I want to be a nurse!!!!

Daniela

Can't remember the test's name. Think it was an ELISA test; but, not sure. Didn't need a specialized lab. The employee health nurse at a hospital I started at suggested it and the hospital paid for it. Maybe you could call your local hospital's employee health department and inquire?

When I was in school, all I had to do was sign a waiver. Since I had multiple exposures to chicken pox & shingles in the past, I knew that I couldn't catch it; so, I had no problem waiving the school and my clinical facilities of liability if I caught the disease. When I told the employee health nurse my story, she realized that I probably had natural immunity (especially after telling her I cared for my child with chicken pox and my husband with shingles, never caught it, although my titers would have indicated I wasn't immune).

Please don't think that the low titers will stop you from being a nurse. Even if you aren't immune, you can take precautions. The institutions (school, clinical facilities, etc) will only give you that impression because they are trying to save their own butts. I am betting you have natural immunity, unless you were home schooled and never exposed to the general population while a kid.

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