Immunizations?

[GatorRX]

Hi all --

I just read the student handbook for UF College of Pharmacy. Their immunization policy wants to see proof of MMR (like most colleges) and a Hepatitus B. Is the Hepatitus B usually given to us as school children (I don't remember this one!)? They also want a TB skin test done every year! Do they actually enforce this (at UF)?

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[Caverject]

If you went to a florida high school like I suspect, you got it upon entering the 9th grade. However, that shot is only good for 10 years so you may have to do it again.

 

[dgroulx]

UF makes you get your vaccines. If you've had them, your doctor still needs to fill out the health form provided in your acceptance information packet. They will hold up your registration for classes if you don't send in the form.

BTW, I think that the Hepatitis B vaccine is optional. At least it was last year.

 

[GatorRX]

UF makes you get your vaccines. If you've had them, your doctor still needs to fill out the health form provided in your acceptance information packet. They will hold up your registration for classes if you don't send in the form.

BTW, I think that the Hepatitis B vaccine is optional. At least it was last year.

What about the TB test? Strictly enforeced literally ever year? Sheesh!

 

[Glycerin]

What about the TB test? Strictly enforeced literally ever year? Sheesh!

That's pretty typical, especially where health professions are concerned. Have you ever had a skin test? It's not bad at all. They'll just need to examine the point of entry 48-72 hours after you've received it.

 

[Glycerin]

Is the Hepatitus B usually given to us as school children (I don't remember this one!)?

Hepatitis B vaccine is a series of 3 shots given over 6 months. The second shot is usually given a month after the first, and the final shot is given 5 months after the second. I never received it as a childhood vaccination, but I did have to get it before I entered nursing school in 1997. I don't think (though I could be wrong) that it is given as a childhood vaccination.

 

[jdpharmd?]

Hep B is usually considered optional as a child/teen. About half of my friends had it just before high school, and the other half got it last summer. We had to provide immunization records and quantitative titers for everything. I think that I had something like 5 shots/blood draws in the months before pharmacy school. I went on a rotation that required another TB series (two in a row), so I got those also. Expect them to either hold up your registration or forbid you to go on rotations until you complete everything. At least one (and maybe 2) TB test(s) per year is pretty much the standard.

 

[imperial frog]

The letter that UF sends out says that chicken pox vaccine is recommended if you hadn't had it as a kid and that HepB, TB test, MMR is mandatory. I passed on the chicken pox then called to make sure and was told it's mandatory, not optional like the letter indicated. Make sure you can prove you had it or get the shot...I have to go back again.

 

[Trancelucent1]

I just had my immunizations 2 weeks ago for UF. The following are mandatory (if your read carefully, the immunization sheet that you must fill out says that some of them are optional as undergrad entering students). Mandatory: TB test (not every year just once), Hep B, proof of chicken pox or vaccine, Tetanus shot (good for 10 years), MMR (two doses- both required for florida students, 1 in elementary, 1 entering 7th grade). The only optional immunization is Meningococcal meningitis (I opted out as it's usually for people living in dorms/tight quarters). I had my Hep B started 3 different times over 5 years (not in the order you're supposed to) but my doctor said that I should have the immunity either way so I only got my last of the 3 shots (hopefully they'll accept it). I just called the clinic where my pediatrician is and had them pull my records out of archive. Luckily the clinic also had a doctor that could give me the immunizations that I was lacking. So he filled out the immunization paper and it was done. GatorRx-There really isn't anything to worry about as you will receive all the forms upon conditional acceptance. It's a pretty easy process to fill out all the forms before school starts!

~Pam

 

[jdpharmd?]

Mandatory: TB test (not every year just once)

The *school* might not require TB every year, but I'm willing to bet that most of the hospital/nursing home *rotation sites* require TB at least once a year. I've had *THREE* required TB tests so far this year alone, and you better believe that I'll be back for more next year.

 

[pharmel]

... I had my Hep B started 3 different times over 5 years (not in the order you're supposed to) but my doctor said that I should have the immunity either way so I only got my last of the 3 shots (hopefully they'll accept it). I just called the clinic where my pediatrician is and had them pull my records out of archive.
~Pam

We (at Midwestern-Glendale) are required to have a lab draw titers to prove immunity for: Measles, Mumps, Rubella, Hep B, and Chicken Pox. We do not have to titer for tetanus, but we do have to have a TB skin test every year, as Jdpharmd? said before. My insurance actually paid for the shots too! Added bonus!

 

[kim.]

We (at Midwestern-Glendale) are required to have a lab draw titers to prove immunity for: Measles, Mumps, Rubella, Hep B, and Chicken Pox. We do not have to titer for tetanus, but we do have to have a TB skin test every year, as Jdpharmd? said before. My insurance actually paid for the shots too! Added bonus!

My insurance paid for all of my vaccinations too! I was thrilled!

 

[pharmaz88]

My insurance paid for all of my vaccinations too! I was thrilled!

...now, we just need to find a way to convince the insurance company to pay for the titers.

 

[bananaface]

The Hep B shots are now somewhat standard, but when I was a kid (I'm 25) they were not given to kids. Most incoming people are not going to have taken them, since we are in the pre-Hep B generation.

My school (UW) is are really strict on the TB screening. It's just a little intradermal test. What is a pain is if you were immunized against TB. Then you come up positive every time and the school wants to treat your for TB even if your immunization was documented. Usually students from outside the US get to deal with this issue.

BTW we pay a mandatory $400 fee then all our immunizations, titers, etc. are covered.

Anna

 

[SeaOtter]

Although UF says that a TB test is required every year, they don't actually enforce it.

 

[dunamis22]

We (at Midwestern-Glendale) are required to have a lab draw titers to prove immunity for: Measles, Mumps, Rubella, Hep B, and Chicken Pox. We do not have to titer for tetanus, but we do have to have a TB skin test every year, as Jdpharmd? said before. My insurance actually paid for the shots too! Added bonus!

what is a titer? i actually got a MMR shot last year as a requirement to volunteer, but i only got a yellow card called an "Immunization Record" with a stamp saying that the vaccine was performed and nothing else. not sure if this will work because usc requires copies of lab reports for "positive quantitative IgG titers"...

thanks.

 

[Roxicet]

what is a titer? i actually got a MMR shot last year as a requirement to volunteer, but i only got a yellow card called an "Immunization Record" with a stamp saying that the vaccine was performed and nothing else. not sure if this will work because usc requires copies of lab reports for "positive quantitative IgG titers"...

thanks.

An antibody titer is a test that measures the presence and amount of antibodies circulating in your blood against certain diseases. Knowing the levels of antibody present in your blood is necessary to determine if you need a booster immunization for a particular disease, or if a recent administration caused a strong enough response from the immune system, bringing your antibody titer against a particular disease up to a preventative level.

I am not looking forward to my shots. I need a tetanus booster (that is overdue by 4 years), the TB test, and a varicella vaccine bc I never had chicken pox. I'll know if I need more shots after my titers for MMR and hepB.

 

[nguyenkd]

My school (University of Houston) requires a TB skin test and 3 doses of Hep. B vaccine. I received 2 doses of the Hep. B vaccine 5 years ago. Does anybody know if this is sufficient? Or would I have to get my third dose? Also, did you get these done by your regular doctor and did insurance cover it? Thanks a bunch! By the way, my childhood immunizations were done by 7 different doctors so I'm going to have fun digging up my records!

 

[Brill]

The hep B vaccine is usually given in three doses within a period of 6 months. I believe there is at least one type of vaccine that is given to some age groups (11-15 I think) in 2 doses though. Your doctor can do a titer to test for antibodies. You may have to get the entire series over again.

 

[bananaface]

nguyenkd - You need your third dose to complete the series. When I got mine done it was at my regular doctor's office and covered by insurance. There should be a number on the back of your insurance card which you can call to find out if your own plan covers the immunization. Digging up those records is no fun! Some of mine were (illegally) incinerated by my physician's office. At least there is no longer documentation floating around that I was a difficult and obnoxious child.

Roxicet - If your doses are documented, the school has no basis to force you to get titers or recieve another dose. No waning immunity has been seen since the Hep B vaccine entered the US market 17 years ago. If it has been over 5-7 years since the series was completed your titers will probably come back negative. But, even people who have completed the series and no longer have positive titers have been shown to still be protected against Hep B. One of my classmates got the 4th dose forced on her, though.

 

[bananaface]

Antibody levels do not correlate with immunity for Hep B. (as described in above post)

According to http://www.cdc.gov/nip/publications/VIS/vis-hep-b.pdf if you miss a dose in the Hep B series you do not need to start over. They just recommend that people continue with the next dose as soon as possible.

The two Hep B vaccines on the market are interchangeable. I have not seen any info leading me to believe that only 2 doses would constitute a series.

But, maybe you have more up to date information, Brill. Do you have any sources to contribute? The CDC is not 100% reliable. (For example, their inactivated influenza vaccine info sheet still says that you might want to wait until December to get your flu shot if flu season is predicted to have a late onset, even though the waning effectiveness of the vaccine is now attributed to viral mutations rather than a short immune response to the vaccine. Arghhh.)

 

[Brill]

Recombivax HB
www.merck.com/product/usa/pi_circulars/ r/recombivax_hb/recombivax_pi.pdf

"For adolescents (11 through 15 years of age), the immunogenicity of a two-dose regimen (10 mcg at 0 and 4-6 months) was compared with that of the standard three-dose regimen (5 mcg at 0, 1, and 6 months) in an open, randomized, multicenter study. The proportion of adolescents receiving the two-dose regimen who developed a protective level of antibody one month after the last dose (99% of 255 subjects) appears similar to that among adolescents who received the three-dose regimen (98% of 121 subjects)."

Even that link you posted mentions a 2 dose regimen

When I missed my third dose at work they made me have a titer done and then redo the entire series. Sounds like I got gipped.

 

[bananaface]

hehe I didn't read that far down. (having been up for 20 hours at that time)

That link is dead to me.

Older people will naturally have a stronger immune response than infants because of their more developed immune system. I would want to see a comparison of like aged individuals. I would also prefer to see some evidence citing protective capabilities rather than relying soley on antibody titer levels.

 

[nguyenkd]

Thanks for the info guys. I called my old doctor to ask about my two doses of Hep. B and apparently, they could not find my file. They came on the phone several minutes later and told me they looked under my dad's file and saw vaccinations for Hep. B. She told me to just write down the dates accordingly (0 months, 1 month, 6 months). I guess I will have to go up there myself and obtain my record to be sure. If this is the case, and I did receive 3 doses, would this be sufficient if it was done 5 yrs ago? Thanks!

 

[flighterdoc]

...now, we just need to find a way to convince the insurance company to pay for the titers.

The CC I'm taking some pre-reqs at will do the immunizations and titers for "free", or part of the $10 health fee. Good deal!

 

[Glycerin]

Off topic, but since it's in your quote, FlighterDoc, that ketchup remark is clever!

 

[bananaface]

Thanks for the info guys. I called my old doctor to ask about my two doses of Hep. B and apparently, they could not find my file. They came on the phone several minutes later and told me they looked under my dad's file and saw vaccinations for Hep. B. She told me to just write down the dates accordingly (0 months, 1 month, 6 months). I guess I will have to go up there myself and obtain my record to be sure. If this is the case, and I did receive 3 doses, would this be sufficient if it was done 5 yrs ago? Thanks!

Whether they will count depends on the spacing and if they are documented properly. For adults the first 2 doses should be at least 1 month apart, and the 2nd and 3rd dose separated by at least 6 months. (The schedule for kids is slightly different). It does not matter how long ago you completed the series. If your doctor did not keep proper vaccination records as required of him by law then you probably have to redo the series or hope for a detectable titer to satisfy your school. (Isn't it the last 20 years that records were required to be kept on file permanetly? - the vaccine has been out 17 years so all Hep B vaccinations should have been permanetly recorded.) If you had the series and your doctor didn't retain your vaccination records, the doctor should be liable for the costs of your titer and/or series. Destroying/losing records of vaccinations is now illegal.

 

[Trancelucent1]

I started my hep B series about 5 years ago. I received the first and the second one a month later, but never went back for the third shot. When I went to get my shots for school a few months ago, my doctor told me that I should be immune no matter how long they were spaced out. He said that there have been a lot of publications coming out lately that say it doesn't matter about the spacing in the shots. He also said that some doctor's are not accepting this. Luckily, UF told me that as long as I had the three shots, I was ok.


~Pam

 

[bananaface]

If the shots are spaced out further than the guidelines it is ok. If they are spaced a shorter time, then you run into problems. If your body is still mounting an active immune response from one shot while another shot is administered, then the latter shot will be deactivated by the immune system without generating the big bump in immunity.

I'm sorry for the confusion. I should have stated this explicitly before.

 

[Roxicet]

I went to my Dr today to get my tetanus shot and Tb test, but she decided to order the titers for MMR, varicella, and hepB first, bc she said that the vac. for tetanus and the Tb test might interfere with the titer results. Problem is, I don't think my insurance will pay for these titers unless she can prove they're medically necessary. So I'm hoping I don't get a huge bill in the mail next week. The only titer I think can be justified is the varicella one, bc I'm not sure if I ever had chicken pox, and my mom doesn't remember either, so if I don't have Abs, then I do need this vaccine. But now I need to make another trip to get the tetanus and Tb next week, and I'm scared to check my mailbox

 

[GravyRPH]

I'm sure you'd remember if you had it. It's quite....memorable.

 

[Roxicet]

I'm sure you'd remember if you had it. It's quite....memorable.

Yeah, my cousin got chicken pox when he was 19, and he had them on his tongue!!!

 

[de javu]

Folks,

What is going to happen if I only had the first 2 shots of HepB? I understand that the third shot needs to be given at least 5 months after the second shot. However, I just had my second shot 2 weeks ago, and my school starts in early September this year. Worse yet, I need to submit my immunization records at the orientation, which is scheduled for next month. What can I do now? *sigh*

 

[jdpharmd?]

Folks,

What is going to happen if I only had the first 2 shots of HepB? I understand that the third shot needs to be given at least 5 months after the second shot. However, I just had my second shot 2 weeks ago, and my school starts in early September this year. Worse yet, I need to submit my immunization records at the orientation, which is scheduled for next month. What can I do now? *sigh*

You'll be fine. What else can you do? Just submit what you have and then turn it in again when you finish the series.

 

[28657]

I went to my Dr today to get my tetanus shot and Tb test, but she decided to order the titers for MMR, varicella, and hepB first, bc she said that the vac. for tetanus and the Tb test might interfere with the titer results. Problem is, I don't think my insurance will pay for these titers unless she can prove they're medically necessary. So I'm hoping I don't get a huge bill in the mail next week. The only titer I think can be justified is the varicella one, bc I'm not sure if I ever had chicken pox, and my mom doesn't remember either, so if I don't have Abs, then I do need this vaccine. But now I need to make another trip to get the tetanus and Tb next week, and I'm scared to check my mailbox

CPG gives you an additional $400 or $500 of financial aid your first quarter to help cover the titer costs.

 

[bananaface]

I had to pay a $400 immunization fee regardless of what I did or didn't need.

 

[de javu]

thank you, jdpharmd. I will call my school tomorrow to confirm.

 

[Roxicet]

hmmm...turns out I did have chicken pox at some point; the titer was +.

 

[BananaSplit]

Hi folks,
I just got off the phone with my mom and she told me that during our last move, she threw out my immunization records from China. (I asked her why she did it, and she said she didn't know I would need them anymore since it's been more than a decade). So now, I have no record of my early vaccinations.

For MMR, I can just retake the vaccinations or get a titer/serology report.

But what can I do about the tetanus and diptheria requirements? My school says that the students are required to have evidence of the primary series of tetanus and diptheria...but the primary series is 3 doses (0, 4 weeks, 6-12 months).

I know Californian students are required to have certain immunizations...do you think my elementary/middle/high school may still have records? I don't know why they would...unless they keep student files for decades. Sigh.

Wanna know something really sad (pathetic)? We keep immaculate health records for our dog. We know exactly when he was vaccinated for what.

 

[28657]

Hi folks,
I just got off the phone with my mom and she told me that during our last move, she threw out my immunization records from China. (I asked her why she did it, and she said she didn't know I would need them anymore since it's been more than a decade). So now, I have no record of my early vaccinations.

For MMR, I can just retake the vaccinations or get a titer/serology report.

But what can I do about the tetanus and diptheria requirements? My school says that the students are required to have evidence of the primary series of tetanus and diptheria...but the primary series is 3 doses (0, 4 weeks, 6-12 months).

I know Californian students are required to have certain immunizations...do you think my elementary/middle/high school may still have records? I don't know why they would...unless they keep student files for decades. Sigh.

Wanna know something really sad (pathetic)? We keep immaculate health records for our dog. We know exactly when he was vaccinated for what.

I also don't have my shot records, but that's whole other story. You can try to call your high school. I called mine and the secretary told me that our principle had decided just a month earlier to throw away graduate records.

I got titers drawn for MMR, Hep B, and Varicella. Because I didn't have proof that I had had a tetanus shot within the last 10 years I had to get another one. Tetanus shots are pretty cheap - like $25. My measles came back negative for antibodies so I had to get a booster shot and omigod that hurt like a bitch!

 

[bananaface]

If it makes you feel better about your mom tossing the records, the people in my class who were vaccinated outside of the US had to get titers on most things anyway.