hepatitis B vac sequencing

[crys20]

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Hi guys,
I got my 1st of the hep B series in January, then slacked a bit and got the 2nd in April...And the nurse told me I couldn't get dose #3 until October (6 mo after the 2nd one I just got)...Is that right? Everything I always read made it seem like you just needed 6 mo to separate doses 1 & 3 and less time between 2 & 3.

 

[ssdoc]

Hi guys,
I got my 1st of the hep B series in January, then slacked a bit and got the 2nd in April...And the nurse told me I couldn't get dose #3 until October (6 mo after the 2nd one I just got)...Is that right? Everything I always read made it seem like you just needed 6 mo to separate doses 1 & 3 and less time between 2 & 3.

From what I know, its supposed to be 1 month between the 1st and 2nd dose and 5 months between the 2nd and 3rd dose.

 

[odrade1]

You can get the last dose later; it won't matter if the nurse is wrong and you wait an extra month.

In my case, my insurance lapsed after my second dose, and it was 4 years later that I asked my new doctor about finishing the sequence. He ran an immunity test and apparently I am immune after just 2 shots. saved me a few bucks, I guess...

 

[hunter1077]

They should check your titer before you get into medical school so dont worry. I took my three and then had to have three booster shots before I built an antibody.

 

[crys20]

So it won't matter if I don't have the final dose before I start?

I'm just worried since I start school July 31 and have to return the immunization records June 30 and this last shot won't be on there.

 

[hunter1077]

So it won't matter if I don't have the final dose before I start?

I'm just worried since I start school July 31 and have to return the immunization records June 30 and this last shot won't be on there.

Just MAKE SURE the school checks your titer.

 

[ssdoc]

So it won't matter if I don't have the final dose before I start?

I'm just worried since I start school July 31 and have to return the immunization records June 30 and this last shot won't be on there.

It all depends on the school. Some schools are ok with you still having to get the 3rd dose after school starts, but others require you to have all 3 done beforehand. You should call the school and ask them. You start pretty early, you are probably fine.

 

[BerkeleyMD]

Vaccinations for HBV are given at 0,1,6 months. I think there is a bit of room if you are off by a couple of weeks.

My school just wants us to start the sequence before the start of the first day of class and complete it before the end of the first year.

Check with your school.

 

[basupran]

There is also an expedited sequence...I think it was 0,1,3 but I can't remember right now. You can check with the manufacturer or the insert. Titer wont be as high but you can get by with it (if you need it for clinicals).

 

[deleted87716]

It's 3 doses (0, 1-2, 4-6 months). The minimum interval between doses 1 and 2 is 4 weeks, between doses 2 and 3 is 8 weeks, and between doses 1 and 3 is 16 weeks. See schedule.

 

[crys20]

Ok, so if the min b/w dose 2 and 3 is 8 wks and I got my dose 2 on Apr 17, could I not get dose 3 on Jun 17, as opposed to Oct 17 which is what the RN told me?

 

[deleted87716]

Ok, so if the min b/w dose 2 and 3 is 8 wks and I got my dose 2 on Apr 17, could I not get dose 3 on Jun 17, as opposed to Oct 17 which is what the RN told me?

Yes, indeed.

 

[aus1ander]

Another good source of information:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5416a3.htm

This also includes information about post-vaccination serology and what you should do if you test titer negative after receiving the 3 shot series.

As stated before, you do not need to wait 6 months until your 3rd shot. The minimum time between #2 and #3 is 8 weeks. There would be no go reason to wait 6 months for your third shot.

 

[DentalGal]

You can get the last dose later; it won't matter if the nurse is wrong and you wait an extra month.

In my case, my insurance lapsed after my second dose, and it was 4 years later that I asked my new doctor about finishing the sequence. He ran an immunity test and apparently I am immune after just 2 shots. saved me a few bucks, I guess...

Same thing happened to me - I never went to get the third shot when I was younger, but they ran a test, and I'm immune after two shots.

 

[crys20]

Great guys, thanks, I had a feeling the nurse was wrong but I didn't want to get into an argument with her with little kids waiting to get shots. Would it make any difference at all to the 8 wk rule because I waited so long (12 wks) b/w dose 1 and 3 (dose 1 was on jan 17 i believe)

 

[emack]

I think the general answers to your repeated and very specific questions are:
1) go find someone who will give you the third shot sometime this summer
2) get a titre done
It's not a perfect science. Stop stressing over differences of a few weeks or months; even with 3 perfectly timed shots the response is really variable. Hence the titre, need for boosters, etc.

 

[crys20]

Thanks so much for your help. I guess my fear is not so much whether or not I'll be immune to hepatitis B in July (i'm aware that the shot is perfectly effective w/ widely variable dosing) when school starts but moreso that not having all three shots on my record will logistically be a problem with starting school, ICM class and preceptorship, etc. I could just call the school and see, my question was more that I was unsure of the dosing schedule and was wondering if the RN at the health dept was right in telling me I couldn't come back until October. But thanks. 🙂

 

[ForeverStudent]

Vaccine Ingredients
I never got vaccinated and after reading the ingredients and how vaccines are produced, I am so happy I was never given any shots.

Besides, it doesn't make sense to me to inject Hepititis B into my body when I will never practice unsafe sex nor share needles.

Anyways, all I had to do was sign the form from the nurse and get it notarized saying I was a conscientious objector.

 

[odrade1]

Vaccine Ingredients
I never got vaccinated and after reading the ingredients and how vaccines are produced, I am so happy I was never given any shots.

Besides, it doesn't make sense to me to inject Hepititis B into my body when I will never practice unsafe sex nor share needles.

Anyways, all I had to do was sign the form from the nurse and get it notarized saying I was a conscientious objector.

just wait till you get an accidental needlestick.

I hope you don't share this line of reasoning with your patients...

 

[omgwtfbbq?]

Don't worry too much if the timing of the vaccines is off. I had really bad delayed reactions to the shot and i waited a year before taking the 3rd one!!!!! and after that not fun experience i found myself in a job at the children's hospital requiring the vaccines. Unfortunately, since i had taken them a bit out of sequence i didn't know if it had worked.

So I had an antibody test to see if the vaccines worked... and they HAD! (horrah!) so if you've taken them out of sequence there isn't a need to start over as my university nurse suggested. get checked out first after that third shot.

 

[ForeverStudent]

just wait till you get an accidental needlestick.

I hope you don't share this line of reasoning with your patients...

It is my goal to help my patients be healthy, not get them sicker or damage their bodies.