Questions regarding immunizations for nursing school...

pookapooka · Jul 3, 2011

That sounds a little excessive.

I had titers done for MMR, Hep B, and Varicella. I was able to find my childhood immunization record, so if my titers are negative, I don't have to have them all again.

I did get a Tdap. It had been so long since I'd had a tetorifice booster, and I don't think I ever specifically had a Tdap. It was something else when I was a kid.

Also you probably have to have a boosted TB skin test. Basically, you get the injection, then 48-72 hrs you go back to have it read. Then, 1-3 weeks later you go back and get it again, having it read 48-72 hrs after the injection.

You might want to call your school for clarification if some of your titers come back negative. You might not have to start everything over if you've been immunized before.

Good luck!

OB-nurse2013, BSN, RN · Jul 3, 2011

Thats pretty normal. I had to order my state records proving I had the MMR vaccine and then I had to get the hep b vaccine, TDap (sucks) and you probably had the first ones unless you weren't born here, and TB test..We also had to have a very basic physical and I did think it was a lot but whatcha gonna do?

silverbells_star · Jul 3, 2011

Yep, same things at my school

mommywithplenty · Jul 3, 2011

I need proof of up to date vaccinations such as MMR, proof of varicella, HIP B is just suggested and so is the flu. I don't have documented HIP B but I remember getting it as well as the chicken pox as a kid though I did get blood work done. I'm half way done my 2 step TB test. I went to the Dr.'s one day, had it read 2 days later, already booked for next week to do the 2nd step. The thing with the TB test is that you may have to wait on the immunizations until you have the TB test done. So get the TB test out of the way first as well as the titters as the results can take a while to come back.

Twinmom06, ASN, APN · Jul 3, 2011

I had MMR titers drawn and showed proof of immunity so that was all good - never had chicken pox OR the vaccine so I had to get one shot and then 4 weeks later get the other one...

TB was done one week apart and each shot was read 48 hours afterward

Hep B I had done in 1994 so that was ok, and I had to get a tetorifice shot...

if your titers are positive (still showing immunity) as well as Varicella then you shouldn't need too many shots...

piscesgrl389 · Jul 3, 2011

sounds like the same list of vaccinations i had to do for my school! and boy was it a pain in the butt!! my nurse practitioner even told me she never saw a list so extensive for shots lol...1st when i got my lab test done they did it qualitative instead of quantitative.. the office refused to redo my test.. i didnt show immunity for titter and Hep B.. so i got my 2nd step tb shot.. MMR and 1st Hep B shot ( there are 3... takes about 6 months to finish ) all in one day. Had to go back for my 2nd Hep B shot ( 3rd one is 5 months after) but the tdap was the worst.. since its a new shot (came out 2006 ) and my primary care physician office claimed they never heard of it... after 2 months of going back and forth i finally just took the shot at the my school paid 56 dollars... and got my blood drawn correctly for my hep b result... lol i guess in other words you should be fine =)

FLDoula · Jul 3, 2011

Sounds about right. I had the Hep B series in 2005 and had a MMR in 2007 because of being a Birth Doula/Lactation Counselor. (I'm 50 and actually had Mumps, Rubella and Chicken Pox but not Measles that I know of) My Tdap is up to date so I only had to get the flu/H1N1 and TB test. Titers were all good. I'm fortunate. Some of the older students had not had those vaccines (they were not even around when we were getting childhood vaccines)

dudette10, MSN, RN · Jul 3, 2011

I had titers done for MMR, Hep B, and Varicella. I was able to find my childhood immunization record, so if my titers are negative, I don't have to have them all again.
I did get a Tdap. It had been so long since I'd had a tetorifice booster, and I don't think I ever specifically had a Tdap. It was something else when I was a kid.
Also you probably have to have a boosted TB skin test. Basically, you get the injection, then 48-72 hrs you go back to have it read. Then, 1-3 weeks later you go back and get it again, having it read 48-72 hrs after the injection.
You might want to call your school for clarification if some of your titers come back negative. You might not have to start everything over if you've been immunized before.
Good luck!

Did someone advise you that if your titers are negative, proof of prior immunization is good enough?

Negative titer = no proof of immunity, regardless of vaccination history. If you have proof of immunization, and a negative titer won't require a re-vaccination, what's the point of getting titers to begin with?

JustBeachyNurse, LPN · Jul 3, 2011

Negative titer = needs re-vaccination or a booster shot.

My Hep B which was positive for immunity for over a decade came back equivocal. I had to get a Hep B booster shot with repeat titer in a month. Fortunately my titer came back positive/immune.

15+ years ago TDaP (Tetorifice, Diphtheria & acellular pertussis) was DTP (Diphtheria, Tetorifice, Pertussis) and adult boosters were just TD (Tetorifice & Diphtheria). In recent years it was discovered that the pertussis immunization did not carry through to adulthood. Exposed adults were then exposing newborn/young infants to whooping cough with devastating results. Hence now when you are due for a tetorifice booster the TDaP is recommended.

It is also possible to have had varicella as a child and not have positive/immune titers. My siblings and I had chicken pox over a 10 week period. While my chicken pox titer is very highly positive/immune, one of my sisters does not have a positive varicella titer and was required to get a booster before she could work in a school or healthcare setting. (with a titer drawn post vaccination)

Just because you have your childhood immunization records does not mean that you are immune. If you have your childhood records and your titers are negative for immunity you will still need to be vaccinated again or choose another line of work. Unlike the flu shot certain vaccinations are not optional for entry into nursing school/health care. There has to be a valid medical reason to delay/skip a required immunization. (For example, pregnancy where no live vaccines can be administered.)

I was required to have proof of immunity for measles, mumps, rubella, chicken pox, hepatitis B, proof of recent (within the past 8 years) vaccination for TD/TDaP, and a two step TB screening. All vaccines & testing were available at low cost from the local health department as not all insurance companies cover adult titers & immunizations. Anyone who could not prove immunity/vaccination without a valid medical reason (such as failure to convert from hepatitis B or pregnancy & unable to get a live vaccine) was prohibited from clinical rotations and thus dismissed from the program. There were no other reasons accepted, if it is against your beliefs to be vaccinated then too bad.

JustBeachyNurse, LPN · Jul 3, 2011

Oh and those who were not born in the US and therefore received a BCG vaccination were exempt from the two-step PPD but were required to submit a report of a chest x-ray negative for Tb. The health department offered low cost chest x-rays for those who could not have a PPD due to previous exposure or BCG vaccination.

hayleyh31 · Jul 3, 2011

We had to show proof through shot records of MMR, Hep B, TDaP, Varicella, Flu and one negative TB test.

I started my shots in March. I had to get my Hep B (never had the vaccine), TDaP, Varicella (I had never had CPox) and I took last years Flu vaccine. I went back a month later to get the 2nd Hep B and Varicella. I will have to go back the first week of September to get the final Hep B and then have a titer done a month after that. Also, our TB test was read 72 hours later.