How can I get out of my TB vaccination requirement?

[ndi_amaka]

I will be starting my 1st year in med school this fall and require a TB immunization (among others) to start school.

I have taken many TB tests before and always get a positive skin reaction. This requires me to go and get Xrays to show that my lungs are clear.

Normally, i would have no problem doing this now but I don't have health insurance and I am not willing to dole out cash for Xrays and shots. Plus each time i get the shot, the skin rash gets worse.

I was planning to get a copy of my medical records from the last place I got an Xray but it involves alot of paper work and $55 just to get a copy.

Does anyone else have this problem and how did you handle it?

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[adamj61]

I will be starting my 1st year in med school this fall and require a TB immunization (among others) to start school.

I have taken many TB tests before and always get a positive skin reaction. This requires me to go and get Xrays to show that my lungs are clear.

Normally, i would have no problem doing this now but I don't have health insurance and I am not willing to dole out cash for Xrays and shots. Plus each time i get the shot, the skin rash gets worse.

I was planning to get a copy of my medical records from the last place I got an Xray but it involves alot of paper work and $55 just to get a copy.

Does anyone else have this problem and how did you handle it?

Get one of those little cards or forms and have some nurse you know "read" it...don't have the school read it, say you have to be out of town or something. The mayo clinic made me take 2 tests! I had my mom read the second, it was a waste of time

 

[Pinkertinkle]

At some hospitals, if you volunteer, they'll xray ya for free. It's too bad X rays are only good for like a year.

 

[Treg]

Did you receive the bcg vaccine somewhere? That would result in you always getting a positive skin test (otherwise a positive skin test means you are TB+). They will freak out if you have a positive test and make you do the x-rays unless you can prove that you had the bcg vaccine.

I think that the occupational health and safety dept. at your med school should be able to help you. They should also cover the testing/x-rays etc. should you need them (I think).

Good luck!

 

[angstrom55]

I tested positive a while back so now i just take the x-rays. I'm not quite sure if you can fulfill the tb requirement with anything else except for an x-ray if you've tested positive.

 

[skypilot]

If you have a positive PPD (skin rash from the TB skin test) you should never have the PPD skin test again. You could have a very serious reaction if you have this test again. You will however need to get a copy of your most recent chest Xray and forward it to the school. That should be sufficient.

 

[MEG@COOL]

If you have a positive PPD (skin rash from the TB skin test) you should never have the PPD skin test again. You could have a very serious reaction if you have this test again. You will however need to get a copy of your most recent chest Xray and forward it to the school. That should be sufficient.

What type of reaction?

 

[meltmyfaceoff]

i had the bcg when i was a kid so since ive tested positive i just go get the xray straight away...60 bucks isn't so bad really. i enjoy these medical school loans which allow me to say 60 bucks isn't so bad.

 

[medic170]

Get one of those little cards or forms and have some nurse you know "read" it...don't have the school read it, say you have to be out of town or something. The mayo clinic made me take 2 tests! I had my mom read the second, it was a waste of time

Falsifying medical records may not be the best way to start your medical career. You need to do the x-rays. They require it for a reason, don't try to circumvent this. It is required for your protection, the protection of your fellow students, and for the protection of your patients!

 

[ravaha08]

Don't you have to have health insurance just to go to medical school? I don't see why it would not be a requirement. I would think most student health insurance plans would cover the tests and x-rays. I was told by my school that I could wait for orientation and get the skin tests free. You can probably get the X-rays taken care of somehow. Also, if you are getting student health insurance, you may be able to wait til classes begin to get the x-rays. Just talk to your school's health services.

 

[exmike]

Don't you have to have health insurance just to go to medical school? I don't see why it would not be a requirement. I would think most student health insurance plans would cover the tests and x-rays. I was told by my school that I could wait for orientation and get the skin tests free. You can probably get the X-rays taken care of somehow. Also, if you are getting student health insurance, you may be able to wait til classes begin to get the x-rays. Just talk to your school's health services.

you get health insurance as a student, which is required. what happens before you enroll is up to you.

 

[beanbean]

Check with your school. We were offered TB tests and Hep B vacs during orientation by Employee Health.

 

[ravaha08]

What I was trying to say was that some schools, such as the one I will be attending, will let you fulfill that requirement after you receive your student health insurance benefits after you start classes. You just need to find out if that is the case.

 

[Zweihander]

Oddly, I've gotten the bcg and I don't come up positive for TB.

 

[bullsI]

Get one of those little cards or forms and have some nurse you know "read" it...don't have the school read it, say you have to be out of town or something. The mayo clinic made me take 2 tests! I had my mom read the second, it was a waste of time

you're really setting yourself up for serious repercussions. but that might go along well with your alcohol citations you're also hiding on your med school apps.

 

[adamj61]

My mom is a nurse, so she can read it. Mayo made us do two, which I thought was pointless. There is really no way to get out of a TB test unless you have someone else read it....that was my point.

Also, the amcas app asks for institutional action, sorry, but my school doesn't give a damn about underage drinking tickets. We are the #1 college town, number 2 party school in the country, they would have to hire a whole new office to deal with that. So I am not hiding anything....if a secondary asks, I will tell them.

 

[sistahnik]

zwiehander, you are showing positive b/c of the bcg vaccination not necessarily b/c you have TB.

ndi_amaka, if you had the bcg, then you need to verify that with your records. I used to work in peds as and whenever I did vaccines I always confirmed with the parents if the child had the bcg vacc previously before giving them the skin test. If you aren't sure if you had bcg, then ask your parents if you had it!!! you need to get this worked out, because just saying that you test positive everytime isn't going to get you out of taking the tb skin test. protocol is to get x-rays to show whether you've been exposed or if you actually have TB, so don't worry just do it!!

 

[josephgoro]

I will be starting my 1st year in med school this fall and require a TB immunization (among others) to start school.

I have taken many TB tests before and always get a positive skin reaction. This requires me to go and get Xrays to show that my lungs are clear.

Normally, i would have no problem doing this now but I don't have health insurance and I am not willing to dole out cash for Xrays and shots. Plus each time i get the shot, the skin rash gets worse.

I was planning to get a copy of my medical records from the last place I got an Xray but it involves alot of paper work and $55 just to get a copy.

Does anyone else have this problem and how did you handle it?

find an an indian doctor; they are more familiar with PPD false positives than american doctors are, and if you explain to him/her that you were not born in the states (i'm simply assuming so) and your situation, they'll likely be "lienient" in reading your induration diameter.


most doctors don't know how to read it properly, anyway.

i, on the other hand, can't find a pcp who takes my insurance

 

[medic170]

My mom is a nurse, so she can read it. Mayo made us do two, which I thought was pointless. There is really no way to get out of a TB test unless you have someone else read it....that was my point.

Also, the amcas app asks for institutional action, sorry, but my school doesn't give a damn about underage drinking tickets. We are the #1 college town, number 2 party school in the country, they would have to hire a whole new office to deal with that. So I am not hiding anything....if a secondary asks, I will tell them.

AMCAS also asks if you have been convicted of any felonies or misdomeanors, and MIP's count for that.

 

[skiz knot]

How can you get out of your TB vaccination requirement?




Drop out of medical school

 

[sacrament]

Oddly, I've gotten the bcg and I don't come up positive for TB.

In many cases, you only test positive after the BCG for a few years up to a decade. Most people will not test positive for the rest of their lives.

 

[Zweihander]

In many cases, you only test positive after the BCG for a few years up to a decade. Most people will not test positive for the rest of their lives.

aha, that makes sense. I remember being told (though don't actually remember per se because I was just a wee tot at the time) that I'd tested positive for TB in the past, but I definitely don't anymore. I think my brother still does though.

Damn third world medicine!

 

[beastmaster]

Question.

Is it alright to take a shower and wash the forearm after the PPD injection? Can it negatively affect the induration reading?

One nurse told me not to shower, others never said anything. Anyone have the scoop on whether or not I can shower tonight??

 

[debvz]

Question.

Is it alright to take a shower and wash the forearm after the PPD injection? Can it negatively affect the induration reading?

One nurse told me not to shower, others never said anything. Anyone have the scoop on whether or not I can shower tonight??

Laughing here. Unless you're planning on washing under your skin, shower away.

 

[gsx56]

to the OP - WHY DONT YOU HAVE HEALTH INSURANCE? that seems so foolish.

 

[TRUE]

to the OP - WHY DONT YOU HAVE HEALTH INSURANCE? that seems so foolish.

What exactly is that suppossed to mean? There are 43 million americans without health insurance. He perhaps happens to be one of them. Maybe he's not covered by school anymore. Maybe he's not working and covered by that. Maybe he doesn't fall under his parent's plan anymore. Regardless, it is not foolish to not be able to afford health insurance.

 

[Farrah]

God! I am s

I will be starting my 1st year in med school this fall and require a TB immunization (among others) to start school.

I have taken many TB tests before and always get a positive skin reaction. This requires me to go and get Xrays to show that my lungs are clear.

Normally, i would have no problem doing this now but I don't have health insurance and I am not willing to dole out cash for Xrays and shots. Plus each time i get the shot, the skin rash gets worse.

I was planning to get a copy of my medical records from the last place I got an Xray but it involves alot of paper work and $55 just to get a copy.

Does anyone else have this problem and how did you handle it?

I work at a TB clinic where I live and I am also part of a state commitee that works on TB policy. Let me just tell you that you can't get out of the TB vaccination. You just cannot. You must complete whatever medication is prescribed and follow through with policy. Ok. I"m tired of hearing of all the excuses people make. The latent virus is present in your body and thus there is always a possibility that it will become active. I suggest you pay whatever is necessary and complete your paperwork. We have one guy here who refused to take his TB preventive medication, he got TB and now he's been on lockdown for the past 120 days in a trailer beside a state prison because the local hospitals won't take him. People don't take TB seriously anymore. this disease is still a threat.

and oh yea make sure that you go to a qualified physician to have your skin test. see if there is a local tb clinic. they are more skilled at seeing whether or not you have tested positive than others. believe me, i have been doing this long enough and there are some stupid doctors that call up the tb clinic who can't make heads or tails of the skin test.

Anyway if you need more information about your situation feel free to PM me and I can help you out or tell u who u can contact.

and oh yea showering won't affect you reading.

 

[daisygirl]

latent virus

Not a virus; it is a bacterial infection.

 

[Farrah]

Not a virus; it is a bacterial infection.

sorry lol i'm out of it today i meant latent infection
wonder what good working at the tb clinic has done me

 

[jtorres]

as long as you have proof that you have taken that shot you should be cool.

 

[ndi_amaka]

to the OP - WHY DONT YOU HAVE HEALTH INSURANCE? that seems so foolish.

I'll make sure to pick some up on my next trip to Walmart.

 

[ndi_amaka]

*sigh*

One more time, I don't have TB. i never have. I test positive every time...then they send me to get stupid xrays only to clear me afterwards. I've never been prescribed medication....BECAUSE I DO NOT HAVE TB.

Everytime you take the shot knowing u will have a positive skin reaction you run the risk of having a serious bodily skin rash. I don't feel like risking that.

If med school offered it free then I' wouldn't open this thread. But they don't. And I don't have the $$$ to go through the process yet another time.

God! I am s



I work at a TB clinic where I live and I am also part of a state commitee that works on TB policy. Let me just tell you that you can't get out of the TB vaccination. You just cannot. You must complete whatever medication is prescribed and follow through with policy. Ok. I"m tired of hearing of all the excuses people make. The latent virus is present in your body and thus there is always a possibility that it will become active. I suggest you pay whatever is necessary and complete your paperwork. We have one guy here who refused to take his TB preventive medication, he got TB and now he's been on lockdown for the past 120 days in a trailer beside a state prison because the local hospitals won't take him. People don't take TB seriously anymore. this disease is still a threat.

and oh yea make sure that you go to a qualified physician to have your skin test. see if there is a local tb clinic. they are more skilled at seeing whether or not you have tested positive than others. believe me, i have been doing this long enough and there are some stupid doctors that call up the tb clinic who can't make heads or tails of the skin test.

Anyway if you need more information about your situation feel free to PM me and I can help you out or tell u who u can contact.

and oh yea showering won't affect you reading.

 

[ndi_amaka]

as long as you have proof that you have taken that shot you should be cool.

I have proof that I have taken it in the past but there is some rule about taking it once a year or something (not sure). I don't have access to my chest xray andgetting it from medical records = alot of paperwork, time and $$$ (I can't believe that not only do I have to pay to get the xray done, but I also have to pay to get access to it....bull****)

 

[ndi_amaka]

find an an indian doctor; they are more familiar with PPD false positives than american doctors are, and if you explain to him/her that you were not born in the states (i'm simply assuming so) and your situation, they'll likely be "lienient" in reading your induration diameter.


most doctors don't know how to read it properly, anyway.

i, on the other hand, can't find a pcp who takes my insurance

Finally....thanks!!! (And yes I was born outside the country).

 

[Ms.Doctor]

I know someone who tested postitive to the PPD, and she simply was given a card with her induration measurement listed on it, and then what her X-ray showed, and then signed off that she did the med regime for prophylaxis (not sure if that's all necessary if the Xray is clean). You should get a card like this-- it's specific for PPD readings. Sorry I can't give you more info. But once you are positive, you don't have to take the PPD again.

 

[Ms.Doctor]

Not really a heavy explaination, but this is a patient handout site... Just kind of addresses some stuff very briefly.

http://www.nlm.nih.gov/medlineplus/ency/article/003839.htm

 

[the END.]

I have proof that I have taken it in the past but there is some rule about taking it once a year or something (not sure). I don't have access to my chest xray andgetting it from medical records = alot of paperwork, time and $$$ (I can't believe that not only do I have to pay to get the xray done, but I also have to pay to get access to it....bull****)

I don't know any program that would continue to PPD test a person with a history of previous BCG vaccination.
The "some rule about taking it once a year" part confuses me. The BCG is a single shot vaccine (unless it fails to convert the PPD). Are you sure you aren't confusing the PPD test with the BCG vaccine? The PPD is the tuberculin test they do by injecting the protein fluid just under your skin and looking for a bump to develop (to see if you were exposed to TB). The PPD is typically done once a year.
The BCG is a shot to prevent TB (not very effective and not routinely given in the US, though you do say you are from another country so you could have gotten it). The BCG is given once and then the PPD checked to insure it worked (the PPD becomes positive = big bump). Sometimes the BCG fails and it has to be given again. Sometimes really young children are given a booster at 12-15 years old. The BCG would require records like any other vaccine (MMR, tetanus, polio, etc) to prove it were done and that your PPD converted to positive within 3 months of BCG administration. If you have proof of this immunization and can show it to your student health authority, then you should not need to submit to PPD testing because of the fact the test has been tainted by the vaccine and your mentioned outside risk of more serious allergic reaction. You might have to show it to them every year they try to PPD test you, but it would still be just as valid every year.
Furthermore, if you have a full positive result (dependent on your health, where you lived, and any friend/family exposure but likely greater than 10 or 15mm) then that alone precludes future testing regardless of whether you had the BCG vaccine because once the PPD is positive, it pretty much stays that way.
Fight all you want but realize even if you prove you had the BCG, they may still want x-rays even if you don't get the PPD test (there is a chance those who had the BCG vaccine also get TB because it is not a very effective vaccine). Active TB infection develops in 5-15% of those with a positive PPD but negative history, physical, and x-ray.
When you can afford it, if it's still a problem, maybe you should just get a doc to give you some isoniazid for 9 months and that way you have hopefully treated any latent infection (no matter how sure you are you don't have it). There are some mild risks to isoniazid, but if this is such a thorny issue for you maybe you would take the risk. It would give you a way out of future x-rays (though still not 100%).

 

[adamj61]

Use photoshop to make some x-rays...

 

[ndi_amaka]

Thanks. Very informative.

I don't know any program that would continue to PPD test a person with a history of previous BCG vaccination.
The "some rule about taking it once a year" part confuses me. The BCG is a single shot vaccine (unless it fails to convert the PPD). Are you sure you aren't confusing the PPD test with the BCG vaccine? The PPD is the tuberculin test they do by injecting the protein fluid just under your skin and looking for a bump to develop (to see if you were exposed to TB). The PPD is typically done once a year.
The BCG is a shot to prevent TB (not very effective and not routinely given in the US, though you do say you are from another country so you could have gotten it). The BCG is given once and then the PPD checked to insure it worked (the PPD becomes positive = big bump). Sometimes the BCG fails and it has to be given again. Sometimes really young children are given a booster at 12-15 years old. The BCG would require records like any other vaccine (MMR, tetanus, polio, etc) to prove it were done and that your PPD converted to positive within 3 months of BCG administration. If you have proof of this immunization and can show it to your student health authority, then you should not need to submit to PPD testing because of the fact the test has been tainted by the vaccine and your mentioned outside risk of more serious allergic reaction. You might have to show it to them every year they try to PPD test you, but it would still be just as valid every year.
Furthermore, if you have a full positive result (dependent on your health, where you lived, and any friend/family exposure but likely greater than 10 or 15mm) then that alone precludes future testing regardless of whether you had the BCG vaccine because once the PPD is positive, it pretty much stays that way.
Fight all you want but realize even if you prove you had the BCG, they may still want x-rays even if you don't get the PPD test (there is a chance those who had the BCG vaccine also get TB because it is not a very effective vaccine). Active TB infection develops in 5-15% of those with a positive PPD but negative history, physical, and x-ray.
When you can afford it, if it's still a problem, maybe you should just get a doc to give you some isoniazid for 9 months and that way you have hopefully treated any latent infection (no matter how sure you are you don't have it). There are some mild risks to isoniazid, but if this is such a thorny issue for you maybe you would take the risk. It would give you a way out of future x-rays (though still not 100%).

 

[hnbui]

I will be starting my 1st year in med school this fall and require a TB immunization (among others) to start school.

I have taken many TB tests before and always get a positive skin reaction. This requires me to go and get Xrays to show that my lungs are clear.

Normally, i would have no problem doing this now but I don't have health insurance and I am not willing to dole out cash for Xrays and shots. Plus each time i get the shot, the skin rash gets worse.

I was planning to get a copy of my medical records from the last place I got an Xray but it involves alot of paper work and $55 just to get a copy.

Does anyone else have this problem and how did you handle it?

well the thing is that if the skin test comes back positive you will need an xray like you have mentioned. The Xray will only dtremine if the tb in your body is active or inactive. If your lungs are clear then it is most likely inactive.

Even if it is inactive you are required to take certain medications. Usually patients with inactive tb, like myself, only have to take one type of medication. The number of months an individual has to take dosaged of this medication can range from 3 to 9.

After you have finished taking your medication, you will not be able to get tb again.

also i would like to add that the tb vaccine, most individuals born outside of the us gets this vaccine, though prevents children from getting tb, it's effects wear off as the person ages. But then again there are some instances that this vaccine actually creates a pseudo positive skin result.

i believe that you can get the septum test too.

 

[YzIa]

AMCAS also asks if you have been convicted of any felonies or misdomeanors, and MIP's count for that.

Actually AMCAS only asks about felonies. Many secondaries ask about misdomeanors other than minor traffic viololations.