Tdap Question?

[j_audrey]

I am starting a new job with a new facility, and needed a Tdap booster. I'm getting so I really hate vaccine/TB test time of year.

I was given the Tdap on Tuesday, ran a low grade fever for a couple day with the extreme fatigue and injection site pain. My only concern is I have swollen lymph nodes under my armpit, and am not sure how long this should take to go away. Anyone else had this issue? Employee Health made it sound really common, but I haven't ever heard of it before, and can't find anything online.

Second Question, How do you all handle TB test reactions? I am allergic to the preservative in the test and get a giant hive where the test is given. I tried to explain this to the outside company that does the testing for the facility (Employee Health reads it) and they made me do it anyway. I have had the QuantiFeron test done at my previous facility, along with the chest Xray, and Employee Health pulled those records and noted my employee file. How do I handle this at my next facility? I am going to be moving again at some point, and as I understand it, the TB test reactions only get worse. (They are for me)

The worst of all this? I'm having to take a break from nursing school due to some personal issues... and I just work in the Central Office!

[Lacie, BSN, RN]

I am unable to take PPD test of any form due to a positive vs significant allergic reaction (my entire forearm became inflammed). I have gotten a chest xray every year in lieu. If you have any type reaction they should not be insisting you take one. Generally a yearly PA/Lat CXR is sufficent.

[nursejoy1, ASN, RN]

I cannot take the PPD either-When I had the reaction- I had sputum test and CXR- both negative. Now I just do a sputum test each year. Tests for acid fast baccilli. You should not take the test agin. It can cause a MAJOR skin reaction.

[rn4babies63]

Our unit manager made it mandatory for all of us to get the Tdap vaccine. Some had no reaction, some had localized swelling, pain. 3 days later, I awoke in the middle of the night with lightening bolt pain going down my arm from the injection site to the tips of my fingers. A few nurses did get swollen lymph nodes either under their arm or in their neck. We were also told that these are all possible side effects of the vaccine. We all survived and are much more sympathetic to the mothers that we give the injection to!

[Circejane]

I had the TDaP several years ago, and had the same reaction as the OP. It's the only vaccine I've had a problem with, and I've had 'em all! The swollen glands will go away soon, if you have an experience like mine.

[CorpsmanRN, BSN, RN]

I've given Tdap to several people and have not had any reports of the side effects you described, sorry. Although they sound like typical possible reactions for any vaccine. I know how it sucks to get a side effect that others have not - sort of freaks you out.

As far as the PPD/TST goes, you are a PPD converter (at least that's what we'd label you as in the military). If a person comes up "positive", they get a CXR & placed on INH therapy for 9mos. They do not get another PPD/TST. I would get the records of your negative CXR results because you're just going to keep getting a reaction. If you aren't getting the "positive" induration but having an allergic reaction to the ppd, then you most definitely should not be forced to get it.

Again, this is how we do it in the military facilities I've worked at. I haven't seen how things are done on the civilian side yet.