Question about titers

Altra, BSN, RN · Aug 2, 2004

When I had my lab work before starting school, I showed a nearly total lack of immunity to mumps, although I had the standard childhood immunizations & boosters as an adolescent. Had to get an MMR vaccine ...

I talked with my doc and he said he sees this fairly commonly - when you're talking about "lifetime" immunity there are a lot of variables that are nearly impossible to predict. One example - shingles, caused by the varicella virus, is increasingly common in the elderly.

NurseyBaby'05, BSN, RN · Aug 3, 2004

The HepB immunization is not effective for certain people. I just got done with Micro this summer and our professor said that it just doen't "take" for some people. He said that it has something to do with the surface antigens not igniting an antigen-antibody reaction. That's the extent of what I remember on no sleep.:zzzzz I'll have to look it up again tomorrow.

RegisteredNurse06 · Aug 3, 2004

I don't really know....I know that my rubella titer was negative even though I had all of my childhood immunizations and then another mmr after having my 2nd child. It was positive during my first pregnancy though I don't know what the number was. Anyway, I just took the mmr on Friday so we'll see if it comes up with this one.

michelle95 · Aug 3, 2004

Hence the problem that I have with the chickenpox vaccine. I mean, I know that you can lose immunity, but, I'm sure it's easier to lose that immunity from a vaccine instead of the "real deal". We are going to see a lot of adults getting severe cases of chickenpox in a few years.

julieK · Aug 3, 2004

I had a similar experience with the Varicella titer - it was completely nonreactive after having the test done at different labs several times. I also had had the chicken pox as a youngster (and my doctor said it has nothing to do with the severity of the course of the illness). Anyway, I had to sign a paper in order to do my clinicals that I was waiving the vaccine. I had to sign a similar paper when I started my first nursing job. I was 5 weeks pregnant and wasn't allowed to get the vaccine. Then, of course, I had an exposure so I had to get the varicella immune globulin. Before I was given that, though, I had them draw another set of titers and sent it to a special lab in California which did a more sophisticated test and discovered that I am indeed immune.

So, what is my point in writing all of this? You should try to find a lab that specializes in the test and have your sample sent there in order to avoid unnecessary further testing and immunizations.

-Julie

hllybenn · Aug 3, 2004

I had the same problem with Hep B- I got it about 7 years ago and never bothered with the last one.

When I started my RN job it tested non reactive. They gave me a booster and it then tested reactive about a month later.

RegisteredNurse06 · Aug 3, 2004

Hence the problem that I have with the chickenpox vaccine. I mean, I know that you can lose immunity, but, I'm sure it's easier to lose that immunity from a vaccine instead of the "real deal". We are going to see a lot of adults getting severe cases of chickenpox in a few years.

That is my fear. It is law here in KY that children have to have the chickenpox vaccine before entering school IF they haven't had the disease itself. My oldest two children have had chicken pox so they didn't have to have the vaccine upon entering school. However, my youngest one has not yet had the disease and I know this sounds horrible, but I actually hope he gets chicken pox before he goes to school simply because I know that if he doesn't, he'll have to have the vaccine, which will likely prevent him from getting the disease as a child. And we all know that it's a much more severe disease in adolescents and adults than it is in children. I'm so afraid that he'll end up having to get that shot to get into school and then the immunity will wane when he is much older and he'll end up very ill from what is usually a mild illness for children.

RegisteredNurse06 · Aug 3, 2004

So, what is my point in writing all of this? You should try to find a lab that specializes in the test and have your sample sent there in order to avoid unnecessary further testing and immunizations.
-Julie

How do we go about finding these specialized labs?

LauraLou · Aug 3, 2004

I had my MMR vaccine as a child. I had another one in college because there was a suspected case of measles in my dorm. When I was tested for nursing school, the labwork showed I was still not immune, so I had to have a third MMR vaccine. Hopefully this third one will work. I am beginning to think the vaccines only last a few years and then they wear off.

Jill1215 · Aug 3, 2004

I went through the required process of the three Hep B shots (at $50 a pop!) and then the $50 titer to find I am not immune. I am one of the ones it does not work on. I had to show my school the titer and they told me there is nothing I can do about it. I wish it worked so I would not have to be nervous about be exposed to it!

BrwnEyedNurs · Aug 3, 2004

Thanks for all the replies.

I rechecked with my doc and they got out a big book of lab tests and looked it up and apparently they tested for the wrong things with the hep B and varicella. They checked to see if I had the disease rather than immunity to it...so I have the titers redone today and in a few days I should get the results. I'm keeping my fingers crossed that they will be positive this time.