Immunization Question

[DBC03]

I got my blood test and immunity results back from the lab and will be seeing my physician next week. The problem is that it seems like i have actual titers for most of my immunizations, but just a 'reactive' or 'non-reactive' for Hepatitis. Based on the results, I'm technically immune, but they didn't include the QUANTITATIVE results - just whether the antibodies were reactive. All others (including varicella) have the quantitative results. When I see my physician, will I need to request additional blood work to get the quantitative titers? It should be easier than the original blood work, since they had me fast for a lipid panel. But, still. This is so frustrating. I chose a physician's office near my volunteering, but it's incredibly inconvenient otherwise.

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[DelayedGratification]

Your physician needs to order the quantitative surface antibody panel

https://www.aamc.org/download/440114/data/immunizationform_hepb_faqs.pdf

 

[DBC03]

Your physician needs to order the quantitative surface antibody panel

https://www.aamc.org/download/440114/data/immunizationform_hepb_faqs.pdf

Thank you! I'm a bit irritated because I brought ALL OF THIS PAPERWORK to the appointment. And I trusted the person (in this case NP) to order the correct tests. Sheesh. I'll have to have a discussion when we meet. At least I don't have to fast again...

 

[Mwooster]

Thank you! I'm a bit irritated because I brought ALL OF THIS PAPERWORK to the appointment. And I trusted the person (in this case NP) to order the correct tests. Sheesh. I'll have to have a discussion when we meet. At least I don't have to fast again...

NP provides the same level of care as a physician 😏

Good for you. I will need to fast before any air balloon can take off with me in it

P.S. awesome profile pic

 

[ineedhelpplse]

So did you get the test done before seeing the physician or does a physician have to order these tests? The receptionist at the doctors office I scheduled for seemed to indicate they could do all the tests in office

 

[DelayedGratification]

So did you get the test done before seeing the physician or does a physician have to order these tests? The receptionist at the doctors office I scheduled for seemed to indicate they could do all the tests in office

The blood draw will be done at the physicians office(however some dont blood draw at the office) and the blood is then sent to a lab that performs the tests

 

[DBC03]

So did you get the test done before seeing the physician or does a physician have to order these tests? The receptionist at the doctors office I scheduled for seemed to indicate they could do all the tests in office

It depends on the physician - they sent me to Quest Diagnostics. So I guess I'll be heading there again.

 

[boogiecousins94]

So I had my doctor fax and hep b titer to the hospital where I work so I could get it some day this week. I said it's for medical school etc. would it be wise to double check if it's quantitative beforehand? I assume I can't tell them to report the results as quantitave if the doctor didn't distinguish can I?

 

[DelayedGratification]

So I had my doctor fax and hep b titer to the hospital where I work so I could get it some day this week. I said it's for medical school etc. would it be wise to double check if it's quantitative beforehand? I assume I can't tell them to report the results as quantitave if the doctor didn't distinguish can I?

The lab results will either be quantitative or qualitative

 

[Lannister]

Thank you! I'm a bit irritated because I brought ALL OF THIS PAPERWORK to the appointment. And I trusted the person (in this case NP) to order the correct tests. Sheesh. I'll have to have a discussion when we meet. At least I don't have to fast again...

Your question has already been answered but just wanna say, I feel you. My doc was supposed to order my titer a month ago when I got the last shot, so I could immediately go get it done when it was time. Didn't order it. Called two days ago asking them to order it, said they'd ask and call me back. Haven't called back. School is harassing me every day to get it done.

Hep B is the bane of my existence.

 

[DelayedGratification]

Your question has already been answered but just wanna say, I feel you. My doc was supposed to order my titer a month ago when I got the last shot, so I could immediately go get it done when it was time. Didn't order it. Called two days ago asking them to order it, said they'd ask and call me back. Haven't called back. School is harassing me every day to get it done.

Hep B is the bane of my existence.

The worst is when your titer doesn't show immunity

 

[DBC03]

The worst is when your titer doesn't show immunity

If my qualitative is reactive, do I at least have a hope of having a positive titer?

Thankfully everything else was quite positive!


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[Lannister]

The worst is when your titer doesn't show immunity

YEP.
Had the series when I was a baby. Negative titer. School told me get a booster and a positive titer and that would be sufficient, so I did that and showed them the positive titer and thought I was all good. Six months into M1 I get this passive aggressive email, "uhm, you have had six months, why haven't you completed the full hepatitis B series?". Turns out the people who oversee the vaccine stuff at my school obviously have some communication issues, because they all had different expectations for what we were required to do. So then I had to start the series COMPLETELY OVER because it was too late to go straight to the second shot. So that took like 9 months. And throughout those months I have been getting an email about once a week asking why I'm still non-compliant, despite me having repeatedly explained to them that I'm working on it, and that there is a very strict schedule for hepatitis B vaccines. Then they're like "oh you've gotten the first two shots, just upload your documentation for that while you wait to get the third one so we at least have documentation that you're working on it". Uploaded the documentation. Got rejected because it didn't contain evidence of all three shots and a titer. LIKE I JUST DID EXACTLY WHAT YOU SAID YOU WANTED ME TO DO AND THEN YOU REJECTED IT ANYWAYS!

And now I'm ready for my titer and this effing office will not do its job and ORDER MY TITER. I absolutely guarantee that when they finally do order it, they will order a qualitative titer, which is what happened the first time I tried to order a titer.

😡

/rant.

 

[Jmish1035]

YEP.
Had the series when I was a baby. Negative titer. School told me get a booster and a positive titer and that would be sufficient, so I did that and showed them the positive titer and thought I was all good. Six months into M1 I get this passive aggressive email, "uhm, you have had six months, why haven't you completed the full hepatitis B series?". Turns out the people who oversee the vaccine stuff at my school obviously have some communication issues, because they all had different expectations for what we were required to do. So then I had to start the series COMPLETELY OVER because it was too late to go straight to the second shot. So that took like 9 months. And throughout those months I have been getting an email about once a week asking why I'm still non-compliant, despite me having repeatedly explained to them that I'm working on it, and that there is a very strict schedule for hepatitis B vaccines. Then they're like "oh you've gotten the first two shots, just upload your documentation for that while you wait to get the third one so we at least have documentation that you're working on it". Uploaded the documentation. Got rejected because it didn't contain evidence of all three shots and a titer. LIKE I JUST DID EXACTLY WHAT YOU SAID YOU WANTED ME TO DO AND THEN YOU REJECTED IT ANYWAYS!

And now I'm ready for my titer and this effing office will not do its job and ORDER MY TITER. I absolutely guarantee that when they finally do order it, they will order a qualitative titer, which is what happened the first time I tried to order a titer.

😡

/rant.

Rant on, bro. It's the least you deserve after going through this heck of a mess.
My first titer was negative so I'm in the midst of scheduling a repeat of the series. Won't be back in the US for another month. Hoping that most schools are lenient with those titer deadlines as long as you're getting those immunizations and prepping for that titer. I tried, my antibodies didn't want to cooperate.

 

[DelayedGratification]

I was also negative...currently in the 5 month gap between 2 and 3

 

[DelayedGratification]

If my qualitative is reactive, do I at least have a hope of having a positive titer?

Thankfully everything else was quite positive!


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Considering how much of a mess hep b titer proves to be, your guess is as good as mine

 

[Lannister]

Rant on, bro. It's the least you deserve after going through this heck of a mess.
My first titer was negative so I'm in the midst of scheduling a repeat of the series. Won't be back in the US for another month. Hoping that most schools are lenient with those titer deadlines as long as you're getting those immunizations and prepping for that titer. I tried, my antibodies didn't want to cooperate.

Haha judging by the fact that I was supposed to have this done by July 2016....they're pretty lenient.

 

[kardom11]

Haha judging by the fact that I was supposed to have this done by July 2016....they're pretty lenient.

you can order your titers on your own without wasting time/money on an office visit. requestatest.com

 

[DBC03]

you can order your titers on your own without wasting time/money on an office visit. requestatest.com

I may have to try this. I have to go in for a follow up visit and there’s a quest diagnostics right next to my volunteering location (and I need a TB test), but I’m very tempted to go over everyone’s heads at this point.


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[kardom11]

I may have to try this. I have to go in for a follow up visit and there’s a quest diagnostics right next to my volunteering location (and I need a TB test), but I’m very tempted to go over everyone’s heads at this point.


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Well, I can tell you it's legit. I ordered all my titers through this website and got it done and results back within one week. You can order a quantiferon too but I'm fortunate enough to have a PPD done at work.

 

[moggat]

Have you been accepted/decided on a school yet? Because it probably varies depending on the school and before paying for any more tests you should definitely email their student health and ask. Regardless, I would wait until you get definitive instructions from your school on what they need--could be a qualitative titer is sufficient for matriculation, and if not they'll pay for any more tests you need. (Qualitative positive is probably a quantitative positive)

Also if you have the choice, GO FOR THE QFT. False positive PPDs are pretty common and you don't need the extra CXR radiation or prophylactic 4 months of INH.

 

[MedicalDoge]

Got EVERYTHING done except I was negative for Hep B immunity... just swell.

Both of my schools I am considering say that only a single booster is required if you show immunity after the booster, so everyone make sure you call your schools so you don't have to do more work than necessary!

 

[The Unburnt]

I asked my doctor's office to print out exactly what they ordered so I could make sure they were ordering the quantitative test after verbally asking like 4 times cause I don't trust anyone lol, if the qualitative was positive I'd say you have a good chance of the quantitative being positive too!

 

[DBC03]

I asked my doctor's office to print out exactly what they ordered so I could make sure they were ordering the quantitative test after verbally asking like 4 times cause I don't trust anyone lol, if the qualitative was positive I'd say you have a good chance of the quantitative being positive too!

Embarrassed to admit that I didn’t know they did qualitative tests - wish I had known so I could have verified!


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[Lannister]

Got EVERYTHING done except I was negative for Hep B immunity... just swell.

Both of my schools I am considering say that only a single booster is required if you show immunity after the booster, so everyone make sure you call your schools so you don't have to do more work than necessary!

Also be aware that if you plan on doing any away rotations, you will need to have met that school's requirements for hep B vaccination. So it might just be better to repeat the full series, if possible.

 

[moggat]

Also be aware that if you plan on doing any away rotations, you will need to have met that school's requirements for hep B vaccination. So it might just be better to repeat the full series, if possible.

If you show a sufficiently responsive titer after just the booster then you do have full immunity, your immune system just needed a reminder, so it should qualify for away rotations. You can sometimes tell from the quantitative titer whether you'll need a full series or just a booster too--if you're "low" but detectable a lot of times the booster will work. If you're undetectable (about ~10% of people I've talked to, as far as I can tell), they'll probably make you redo the full set regardless.

HOWEVER, your school should pay for any jabs they require you to get! No need to go overboard and do the full thing over the summer--just wait until you get your matriculation paperwork and can talk to student health. There's plenty of time and they're all REALLY used to dealing with this sort of thing.

 

[DBC03]

I'm immune to Hepatitis B!

So ... what does everyone think of getting the meningococcal vaccine? I thought I had it before college (about 20 years ago), but I can't find a record of it. I wanted titers but the 'friendly' NP didn't want to order it. Thoughts?

 

[MDhopeful324]

I'm immune to Hepatitis B!

So ... what does everyone think of getting the meningococcal vaccine? I thought I had it before college (about 20 years ago), but I can't find a record of it. I wanted titers but the 'friendly' NP didn't want to order it. Thoughts?

I was thinking about that too recently. Our undergrad only required us to received the vaccine if we lived in the dorms, which I didn't. Now I'm reading online (and on a few immunization forms) that one should be receiving it between the ages of 16-23. I don't see any other option. What are us non-trads supposed to do about that?

 

[DBC03]

I was thinking about that too recently. Our undergrad only required us to received the vaccine if we lived in the dorms, which I didn't. Now I'm reading online (and on a few immunization forms) that one should be receiving it between the ages of 16-23. I don't see any other option. What are us non-trads supposed to do about that?

I asked the NP about getting it and she said there might be side effects, just like with every vaccine? I mean, yeah, I get that I could be one of the one-in-a-million people to have a deadly allergic reaction or whatnot, but I think the odds of getting meningitis are better, depending on where you live. I probably am immune because I really do think I had vaccine. But I'll have to see what the options are.