Who's right: the RN or the LPN?

Reigen · Jun 23, 2010

Hep B is given as follows:

first dose date 00/00/00

second dose in one month or 30 days

third dose in 6 months after first dose

followed by a titer blood draw

if you did not complete the doses in 2002 you will need to have all three done

realnursealso/LPN, LPN · Jun 23, 2010

http://www.vaccineinformation.org/hepb/qandavax.asp

"What should be done if a person gets the first two doses of hepatitis B vaccine but never goes back for the final dose? Should the series be restarted?

No, the series does not need to be restarted. If the series is interrupted after the first dose, the second dose should be given as soon as possible; the second and third doses should be separated by an interval of at least 8 weeks. If only the third dose is delayed, it should be administered as soon as possible.

The minimum recommended dosing intervals are 4 weeks between the first and second doses and 8 weeks between the second and third doses. The minimum interval between the first and third doses is 16 weeks"

Hope this helps, according to this, the Health Deperatment Nurse is correct.

Finallydidit · Jun 23, 2010

I have always heard you don't need to restart the series.. You can always do 2 8 wks apart and then have a titer drawn, but that still involves a needle stick. LOL

rn/writer, RN · Jun 23, 2010

Here is another source, confirming that the LPN was correct.

Hepatitis B Foundation: Prevention and Vaccination

If I started the vaccine series but didn't complete my 2nd or 3rd dose on schedule, do I have to start the series over?

No, there is no need to restart the series. If the series is interrupted after the first dose, the second dose should be given as soon as possible, and the third dose at least 2 months after the second. If only the third dose is delayed, it should be given as soon as possible.

Seems logical that a nurse who works at the health department (the place where you get the immunizations, after all) would have more accurate information than another nurse who works at the nursing home.

TheCommuter, BSN, RN · Jun 23, 2010

if you did not complete the doses in 2002 you will need to have all three done

In this case, titers can be a person's life saver. If the titer comes back with a positive result, the original poster may not need any more doses.

I received my first dose of the hep B vaccine back in 2001 and have never completed the series. I have never had to return for the second and third doses because subsequent titers over the years have indicated my immunity to hep B. If the original poster has a positive titer drawn that indicates immunity, then no additional doses should be needed.

FutureMaleOhioNurse, BSN, RN · Jun 23, 2010

Seems logical that a nurse who works at the health department (the place where you get the immunizations, after all) would have more accurate information than another nurse who works at the nursing home.

A nurse that works at the nursing home would have extensive immunization knowledge as well, because after all, almost the entire staff at a nursing home would need essential immunization. Also, the RN has more training/education than the LPN. It is logical to assume that both would have acurate information, which is why I couldn't figure out who was right.

Spritenurse1210, BSN, RN · Jun 23, 2010

The RN is right. You will need to start over.

scu51lly · Jun 23, 2010

I had the same "headache" with my Hep-B series...i kept forgetting to get the follow up shot.

We didn't have to restart the series when I forgot the SECOND shot. However, when I forgot the THIRD shot and went back a year later to get it I had to take the SECOND shot then get the THIRD shot.

I know this doesn't really answer, just thought I relayed my experience.

rn/writer, RN · Jun 23, 2010

Here is the word from on high--the Centers For Disease Control:

If I received the first two shots in the hepatitis B series, but did not receive the third, and it is now 10 years later, should I go ahead now and get the last one?
Regardless of when you started the hepatitis B series, you should just pick up where you left off and complete the series. It is not necessary to add doses or restart the series if the interval between doses is longer than recommended. (6/26/03)

And here is the link:

Vaccines: VPD-VAC/HepB/Questions to NIPINFO

This is the agency that everyone else looks to as the authority on what to do and when to do it. Until there is published research saying something to the contrary, I would follow CDC guidelines.

What TheCommuter said earlier has merit. A titer may show that you have immunity, even though you only had the first injection. You have to look at the cost and inconvenience of obtaining a titer vs. that of getting the other two injections. Then you can make an informed choice.

PedsAtHeart, LPN · Jun 23, 2010

No you DO NOT have to restart the series. Get your 2nd one now, then in 8 weeks you can get your 3rd.

And FYI... just because someone has RN after their name does not mean they know more than someone with LPN (and vice versa).

The health department NURSE was correct, whether she was an LPN or RN doesnt really matter. Health Departments work closely with the CDC and the state to stay up to date on guidelines. Back several years ago, it was thought that if you started the series and did not finish that you would have to repeat the whole series, but that is not the case anymore.

HealthShepherd · Jun 23, 2010

Well, if you need the immunization or proof of immunity for something specific (like a new job, or starting nursing school), then what you need is what they tell you that you need. If the occ. health person processing your file holds one view, then it doesn't matter what the credentials or actual knowledge of your other sources are - LPN, RN, MD, or the CDC itself.

Ask your school/employer what you need to do. Bureaucracy trumps science.